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Microscopic pituitary surgery

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https://www.readbyqxmd.com/read/29017983/endoscopic-transsphenoidal-surgery-outcomes-in-331-nonfunctioning-pituitary-adenoma-cases-following-a-single-surgeon-learning-curve
#1
Jung Hee Kim, Jung Hyun Lee, Ji Hyun Lee, A Ram Hong, Yoon Ji Kim, Yong Hwy Kim
OBJECTIVE: The outcomes of recent endoscopic surgery of nonfunctioning pituitary adenomas (NFPAs) were controversial when compared to traditional microscopic surgery. We aimed to assess the outcomes of endoscopic transsphenoidal surgeries performed by one surgeon with 7 years of experience and elucidate the predictive factors for surgical outcomes for NFPAs. METHODS: We included 331 patients (155 men, 176 women) with clinical NFPAs who underwent transsphenoidal surgery due to visual symptoms by a single surgeon in Seoul National University Hospital from March 2010 to May 2016...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29016590/endoscopic-endonasal-transsphenoidal-approach-to-pituitary-adenoma-a-multi-disciplinary-approach
#2
Deepak Regmi, Amit Thapa, Bidur Kc, Bikram Shakya
BACKGROUND: The excellent visualization and minimally invasive approach employed in endoscopic endonasal procedures has now revolutionized the pituitary surgery, replacing the transnasal microscopic technique worldwide. However, it involves major shift in hand-eye co-ordination from static 3 dimensional images of microscope to 2 dimensional endoscopic images hence demands training and inter-disciplinary approach. Here we present our experiences in learning and developing a safe endonasal transsphenoidal endoscopic approach to resect pituitary adenomas...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28988650/learning-curve-of-endoscopic-pituitary-surgery-experience-of-a-neurosurgery-ent-collaboration
#3
Giorgio Lofrese, Vera Vigo, Mario Rigante, Domenico Luca Grieco, Maddalena Maresca, Carmelo Anile, Annunziato Mangiola, Pasquale De Bonis
For neurosurgeons, who are accustomed to the binocular microscope, there is a new learning curve that must be overcome for monocular endoscopic pituitary surgery. Different studies describe a learning curve between 15 and 200 procedures, after which both operative time and complications stabilize. In this retrospective study, we evaluate the endoscopic learning curve of our group, already trained in microsurgical transsphenoidal surgery, with the assistance of ear, nose, and throat (ENT) surgeons. From 2010 to 2015, a total of 95 patients with pituitary adenomas were treated with a purely endoscopic approach...
October 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28967314/endoscopic-endonasal-pituitary-gland-hemi-transposition-for-resection-of-a-dorsum-sellae-meningioma
#4
Alaa S Montaser, Juan M Revuelta Barbero, Alexandre Todeschini, André Beer-Furlan, Russell R Lonser, Ricardo L Carrau, Daniel M Prevedello
A 69-year-old female with incidental diagnosis of a dorsum sellae meningioma had shown significant tumor growth after initial conservative management. The procedure started with a microscopic sublabial transsphenoidal approach to the sella and the suprasellar space. Due to limitations to a safe dissection and removal of the retrosellar component, the surgery was converted to a purely endoscopic endonasal approach with left hemi-transposition of the pituitary gland, followed by drilling of the dorsum sellae and removal of the left posterior clinoid process...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28960156/identification-and-repair-of-intraoperative-cerebrospinal-fluid-leaks-in-endonasal-transsphenoidal-pituitary-surgery-surgical-experience-in-a-series-of-1002-patients
#5
Ben A Strickland, Joshua Lucas, Brianna Harris, Edwin Kulubya, Joshua Bakhsheshian, Charles Liu, Bozena Wrobel, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Cerebrospinal fluid (CSF) rhinorrhea is among the most common complications following transsphenoidal surgery for sellar region lesions. The aim of this study was to review the authors' institutional experience in identifying, repairing, and treating CSF leaks associated with direct endonasal transsphenoidal operations. METHODS The authors performed a retrospective review of cases involving surgical treatment of pituitary adenomas and other sellar lesions at the University of Southern California between December 1995 and March 2016...
September 29, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28919622/incidence-of-diabetes-insipidus-in-postoperative-period-among-the-patients-undergoing-pituitary-tumour-surgery
#6
M L Kadir, M T Islam, M M Hossain, S Sultana, R Nasrin, M M Hossain
Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28912338/duration-of-post-operative-hypocortisolism-predicts-sustained-remission-after-pituitary-surgery-for-cushing-s-disease
#7
Prachi Bansal, Anurag Lila, Manjunath Goroshi, Swati Jadhav, Nilesh Lomte, Kunal Thakkar, Atul Goel, Abhidha Shah, Shilpa Sankhe, Naina Goel, Neelam Jaguste, Tushar Bandgar, Nalini Shah
PURPOSE: Transsphenoidal surgery (TSS) is the primary treatment modality for Cushing's disease (CD). However, the predictors of post-operative remission and recurrence remain debatable. Thus, we studied the post-operative remission and long-term recurrence rates, as well as their respective predictive factors. METHODS: A retrospective analysis of case records of 230 CD patients who underwent primary microscopic TSS at our tertiary care referral centre between 1987 and 2015 was undertaken...
November 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28860094/qol-and-work-capacity-is-unrelated-to-approach-or-complications-after-pituitary-surgery
#8
Erik Uvelius, Nazia Castelo, Babar Kahlon, Christer Svensson, Anders Cervin, Peter Höglund, Stig Valdemarsson, Peter Siesjö
OBJECTIVE: Endoscopic pituitary surgery has shown favorable clinical outcomes. Less is known about the impact of surgical approaches on health related quality of life (HRQoL) and work capacity. The present study was undertaken to compare transsphenoidal microscope-assisted surgery to endoscopic transsphenoidal surgery regarding preoperative and surgical factors for the final outcome of HRQoL and work capacity. METHODS: In a retrospective study on patients operated for pituitary adenoma, outcome was compared between those operated before and after transition to endoscopic surgery at our department...
August 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28859453/comparison-of-complications-trends-and-costs-in-endoscopic-vs-microscopic-pituitary-surgery-analysis-from-a-us-health-claims-database
#9
Anthony O Asemota, Masaru Ishii, Henry Brem, Gary L Gallia
BACKGROUND: Microsurgical and endoscopic techniques are commonly utilized surgical approaches to pituitary pathologies. There are limited data comparing these 2 procedures. OBJECTIVE: To evaluate postoperative complications, associated costs, and national and regional trends of microscopic and endoscopic techniques in the United States employing a nationwide database. METHODS: The Truven MarketScan database 2010 to 2014 was queried and Current Procedural Terminology codes identified patients that underwent microscopic and/or endoscopic transsphenoidal pituitary surgery...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28820308/resection-of-pituitary-macroadenomas-via-the-pseudocapsule-along-the-posterior-tumor-margin-a-cohort-study-and-technical-note
#10
Davis G Taylor, John A Jane, Edward H Oldfield
OBJECTIVE Extracapsular resection of pituitary microadenomas improves remission rates, but the application of pseudocapsular techniques for macroadenomas has not been well described. In larger tumors, the extremely thin, compressed normal gland or its complete absence along the tumor's anterior surface limits the application of the traditional pseudocapsular technique that can be used for microadenomas. However, in the authors' experience, the interface between the pseudocapsule at the posterior margin of the adenoma and the compressed normal gland behind it is universally present, providing a surgical dissection plane...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28741962/primary-pituitary-tubercular-abscess-as-a-differential-diagnosis-for-sellar-suprasellar-mass
#11
Venkataramana Pamidimukkala, Deepak Sahebrao Mandwe, Siva Ramakrishna K, Harshavardhan Batsala
Only four cases of primary pituitary tubercular abscess have been reported. A 20-year-old ladypresented to us with headache and pituitary dysfunction. Radiology showedsellar tubercular abscess with suprasellar extension. Microscopic examination of pus collected during surgery showed granulomatous tissues and Acid Fast Bacilli. The response to antitubercular therapy was remarkable.
July 25, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#12
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28535639/-curative-effect-analysis-of-two-surgical-methods-for-removal-of-pituitary-adenoma-via-endonasal-transsphenoidal-approach
#13
Y Han, Z Q Jiang, X L Zheng, L Li, F Y Lou, S J Zhang
Objective: To compare the efficacy of endoscopic endonasal transsphenoidal surgery and microsurgery for pituitary adenomas. Methods: One hundred and ten patients with pituitary adenoma who were treated by single nostril transsphenoidal surgery in the department of neurosurgery of the First Affiliated Hospital of Bengbu Medical College from June 2014 to December 2016 were enrolled.These cases were randomly divided into endoscopic group 53 cases (including 36 cases of functional pituitary adenoma and 17 cases of non-functional pituitary adenoma) and microscope group 57 cases (including 34 cases of pituitary adenoma and 23 cases of non-functional pituitary adenomas), with no significant difference in preoperative clinical data about gender, age, tumor size and endocrine function (P>0...
May 23, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28480114/neurosurgery-concepts-key-perspectives-on-endoscopic-versus-microscopic-resection-for-pituitary-adenomas-surgical-decision-making-in-tuberculum-sellae-meningiomas-optic-nerve-mobilization-during-resection-of-craniopharyngiomas-and-evaluation-of-headache-and
#14
Anand V Germanwala, Ryan Hofler, Carlito Lagman, Lawrance K Chung, Alexander A Khalessi, Gabriel Zada, Zachary A Smith, Nader S Dahdaleh, Angela M Bohnen, Jin M Cho, Chaim B Colen, Edward Duckworth, Peter Kan, Sandi Lam, Chae-Yong Kim, Gordon Li, Michael Lim, Jonathan H Sherman, Vincent Y Wang, Isaac Yang
No abstract text is available yet for this article.
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28463614/endoscopic-endonasal-transsphenoidal-surgery-using-the-iarms-operation-support-robot-initial-experience-in-43-patients
#15
Toshihiro Ogiwara, Tetsuya Goto, Alhusain Nagm, Kazuhiro Hongo
Objective The intelligent arm-support system, iArmS, which follows the surgeon's arm and automatically fixes it at an adequate position, was developed as an operation support robot. iArmS was designed to support the surgeon's forearm to prevent hand trembling and to alleviate fatigue during surgery with a microscope. In this study, the authors report on application of this robotic device to endoscopic endonasal transsphenoidal surgery (ETSS) and evaluate their initial experiences. Methods The study population consisted of 43 patients: 29 with pituitary adenoma, 3 with meningioma, 3 with Rathke's cleft cyst, 2 with craniopharyngioma, 2 with chordoma, and 4 with other conditions...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28450934/microscopic-surgery-for-pituitary-adenomas-to-preserve-the-pituitary-gland-and-stalk
#16
Hao-Yu Li, Cheng-Yuan Feng, Chi Zhang, Jun Su, Jian Yuan, Yuanyang Xie, Yiwei Liao, Xianrui Yuan, Qing Liu
Surgery is the primary treatment of choice for all symptomatic pituitary adenomas except prolactinomas. Common postoperative complications include endocrinopathies, vision impairment and cerebrospinal fluid leak. The present study assessed 153 continuous microscopic surgeries for pituitary adenomas performed by an author of the present study between 2010 to 2014. Patients underwent either transphenoidal or transcranial surgery depending on their individual tumor characteristics. Five typical cases are presented in the present study and intraoperative identification and preservation of the gland and stalk were discussed...
March 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28389053/non-functioning-pituitary-adenoma-underwent-surgery-a-multicenter-retrospective-study-over-the-last-four-decades-1977-2015
#17
Pedro Iglesias, Karina Arcano, Vanessa Triviño, Paula García-Sancho, Juan José Díez, Fernando Cordido, Carles Villabona
OBJECTIVE: To assess clinical features, diagnostic procedures, therapies and outcomes in patients with clinically non-functioning pituitary adenomas (NFPAs) surgically treated over the last four decades. DESIGN AND METHODS: A multicenter retrospective study in NFPA patients periodically followed up in specialized neuroendocrinology units who underwent surgery in the period 1977-2015 was performed. RESULTS: A total of 131 patients were studied [66 women (50...
April 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28286277/extent-of-resection-visual-and-endocrinologic-outcomes-for-endoscopic-endonasal-surgery-for-recurrent-pituitary-adenomas
#18
Hyunwoo Do, Varun R Kshettry, Alan Siu, Irina Belinsky, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE: To assess outcomes after endoscopic endonasal surgery for recurrent or residual pituitary adenomas. METHODS: We retrospectively analyzed 61 patients from 2009 to 2016 who underwent endoscopic endonasal surgery for recurrent or residual pituitary adenomas after previous microscopic or endoscopic transsphenoidal operation. RESULTS: The previous surgical approach was endoscopic endonasal in 55.7% and microscopic in 44.2% of patients...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28239067/recent-evolution-of-endoscopic-endonasal-surgery-for-treatment-of-pituitary-adenomas
#19
Hiroshi Nishioka
For the treatment of pituitary tumors, microscopic transsphenoidal surgery has been considered the "gold standard" since the late 1960s. Over the last two decades, however, a worldwide shift towards endoscopic endonasal surgery is in progress for many reasons. These include a wide panoramic view, improved illumination, an ability to look around anatomical corners using angled tip and, in addition, application to the extended approaches for parasellar tumors. Both endoscopic and microscopic approaches appear equally effective for nonfunctioning adenomas without significant suprasellar or lateral extensions, whereas the endoscopic approach may improve outcomes associated with the extent of resection and postoperative complications for larger tumors...
April 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28230605/microscopic-transnasal-transsphenoidal-surgery-for-pediatric-pituitary-adenomas
#20
Wei Jiao, Yimin Huang, Wei Sun, Ting Lei
Microscopic transnasal transsphenoidal surgery (MTTS) has been a time-confirmed effective treatment for pituitary adenomas; however, the data supporting its use in pediatric patients is limited. In this study, the authors summarize the authors' 5-year experience of pituitary adenomectomy via MTTS in a pediatric population. The authors retrospectively reviewed the medical records of 35 patients aged ≤18 years who underwent microscopic transnasal transsphenoidal approach for pituitary adenomas between January 2011 and December 2015...
June 2017: Journal of Craniofacial Surgery
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