Endoscopic surgery of pituitary adenomas. Historical overview

Azizyan, Vilen; Неронович, Азизян Вилен; Grigoriev, Andrey; Юрьевич, Григорьев Андрей; Ivashenko, Oksana; Владимировна, Иващенко Оксана

doi:10.14341/serg201525-14

Cited by 3 publications

(4 citation statements)

References 44 publications

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“…Обезвоживание клеток в результате кристаллиза-ции воды приводит к денатурации белков. Измене-ние осмотического давления, рН и дегидратацию считают дополнительными факторами деструк-ции, к которым особенно чувствительны липо-протеиды клеточных мембран [4,33].…”

Section: Mechanisms Of Tissue Injury During Cryodestruction Cryoimmuunclassified

“…Кроме того, на гибель клеток оказывает влияние на изменение электролитного баланса и рН [4,32,78]. Данные явления происходят на фоне деградации клеточной мембраны.…”

Section: Mechanisms Of Tissue Injury During Cryodestruction Cryoimmuunclassified

“…If the phase transformation areas are passed by cell suspension with keeping very high cooling rates, the dehydration level was esta- замораживании активируются перекисные процессы, приво-дящие к потере холестерина и нарушению функций митохонд-рий [4,32]. На ткани и органы, которые представляют собой сложноор-ганизованные системы клеток и межклеточного вещества, дей-ствуют разные повреждающие факторы.…”

Section: Mechanisms Of Tissue Injury During Cryodestruction Cryoimmuunclassified

“…The application of endometric video-assisted monitoring was established as capable to optimize the surgery tactics. The use of endoscopes with angled optics enabled to greatly extend the clearly visible area during surgery, and to widen the possible manipulations in chiasmosellar area [4]. The selective stereotactic cryodestruction of pituitary adenomas enables to minimize the injury rate, to maximally preserve the intact pituitary tissues, and significantly reduce the risk of postoperative infectious complications and liquorrhea, as well as to improve the life quality of patients [91].…”

Section: эндоскопическая криохирургия грудной полостиmentioning

confidence: 99%

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Endoscopic Cryosurgery

Chizh

2017

Probl Cryobiol Cryomed

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Реферат: В настоящем литературном обзоре обсуждается ряд вопросов, посвященных использованию криохирур-гического способа в экспериментальной и клинической эндоскопической хирургии. С учетом патогенетических механизмов действия низких температур на биологические структуры отмечены преимущества и недостатки применения криохирур-гического метода в лечебной практике. На основании данных клинических исследований показан положительный эффект криохирургических подходов с использованием эндоскопического оборудования и определены перспективы дальнейшего развития эндоскопической криохирургии.Ключевые слова: низкие температуры, криохирургия, эндоскопия, криодеструкция, криоиммунология.Реферат: У даному літературному огляді обговорюється ряд питань, присвячених використанню кріохірургічного методу в експериментальній і клінічній ендоскопічній хірургії. З урахуванням патогенетичних механізмів дії низьких температур на біологічні структури відзначено переваги та недоліки застосування кріохірургічного методу в лікувальній практиці. На під-ставі даних клінічних досліджень показано позитивний ефект кріохірургічних підходів із використанням ендоскопічного обладнання та визначено перспективи подальшого розвитку ендоскопічної кріохірургії.Ключові слова: низькі температури, кріохірургія, ендоскопія, кріодеструкція, кріоімунологія.Abstract: This literature review discusses some issues concerning the use of cryosurgical method in experimental and clinical endoscopic surgery. Considering the pathogenetic mechanisms of low temperature effect on biological structures we demonstrated here the advantages and disadvantages of cryosurgical method application in medical practice. Underpinned by the clinical research data a positive effect of cryosurgical approaches using endoscopic equipment was shown and the prospects for further endoscopic cryosurgery development were determined.Key words: low temperatures, cryosurgery, endoscopy, cryodestruction, cryoimmunology. Комбинированное использование лечеб-но-диагностических систем в эндоскопической хирургииШирокое внедрение видеолапароскопического метода в хирургическую практику позволило значи-тельно улучшить качество проводимых операций [3, 95]. Благодаря постоянному совершенствованию аппаратуры, инструментария и практическому опы-ту врачей малоинвазивные методики проведения операций постепенно вытесняют традиционные, а в некоторых случаях они признаются «золотым стан-дартом» [13, 14, 47].В современной хирургии эндоскопические опе-рации проводятся с помощью различных диаг-ностических установок и лечебных аппаратов. Так, интраоперационную холангиографию применяют при операциях на желчном пузыре и протоках с целью оценки проходимости желчных путей и выбора лечебной тактики [14, 46].Кроме того, в хирургической практике широко используют ультразвуковую диагностику при лапа- Combined use of diagnostic and therapeutic systems in endoscopic surgeryA widespread implementation of videolaparoscopic method in surgical practice has greatly improved the quality of surgeries [5, 89]. Due to a continuous imp...

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Section: Mechanisms Of Tissue Injury During Cryodestruction Cryoimmuunclassified

Section: эндоскопическая криохирургия грудной полостиmentioning

confidence: 99%

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Endoscopic Cryosurgery

Chizh

2017

Probl Cryobiol Cryomed

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Ultrasound Doppler examination in the surgical treatment of pituitary adenomas with cavernous sinus extension

Aksyonov¹,

Palamar²,

Huk³

et al. 2021

Ukr Neurosurg J

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Objective: To determine the effectiveness of intraoperative Doppler ultrasound in the surgical treatment of pituitary adenomas with invasive parasellar growth into the cavernous sinus Knosp 3 and Knosp 4. Material and Methods. During 2009–2017, 71 patients with pituitary adenomas (PA) with extension into the cavernous sinus Knosp 3 and Knosp 4 were retrospectively reviewed. According to the size PA were divided into pituitary macroadenomas, (from 10 to 40 mm) in 45 (63.4%) patients, and giant PA (over 40 mm) – in 26 (36.6%) patients. Cavernous sinus invasion Knosp 3 and 4 was identified in 47 (66.2%) and 24 (33.8%) patients respectively. Non-secreting PA - 43 (60.5%) patients and hormone-secreting PA - 28 patients (39.4%). Endoscopic endonasal trassphenoidal (EET) approach was used in all cases. Laterally expanded EET (LEEET) approach was used in 29 cases. Intraoperative Doppler ultrasound (IDUS) was used in 36 (51%) cases. Results. Intraoperative Doppler ultrasound was used in cases of Knosp 3 extension in 23 (32.4%) cases and in Knosp 4 - in 13 (18.3%) cases. Gross total resection, including extension into the cavernous sinus using IDUS was achieved in 22 (62.7%) patients. In cases where IDUS was not used, gross total resection was achieved in 19 (52.7%) cases. In cases where the IDUS was not used, recurrence rate was 7.3%, with IDUS - 5%. Biochemical remission was achieved in 22 (78.6%) cases. Liquorrhea nasalis after surgery was observed in 6 (8.4%) cases, meningoencephalitis - in 1 (1.4%) case, oculomotor palsy -3 (4.2%) cases. Conclusions. Intraoperative Doppler ultrasound is an informative method that provides safe resection of pituitary adenomas with cavernous sinus extension with a low level of possible postoperative complications. Parasellar extension of Pituitary adenomas into the cavernous sinus Knosp 4 significantly reduces the possibility of gross total resection. However, the use of intraoperative ultrasound makes it possible to determine safe boundaries for manipulation both medially and laterally from the internal carotid artery, increasing the level of radicality and the duration of clinical remission. Intraoperative Doppler ultrasound during endoscopic endonasal transsphenoidal surgery of pituitary adenomas with parasellar extension allows to identify the internal carotid artery in the tumor stroma with the existing changed skull base anatomy. Dura incision under intraoperative Doppler ultrasound reduces the risk of internal carotid artery injury.

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Giant pituitary adenomas, algorithm for selecting a treatment method: surgical, medical, radiological. Literature review

R.V.¹,

Чмутин²,

Chmutin³

2022

Bulletin of Neurology, Psychiatry and Neurosurgery

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This article is devoted to the literature review on the topic of giant pituitary adenomas. The characteristics of giant pituitary adenomas and various methods of treating the disease will be considered. When diagnosing this disease, a clinical examination is not sufficient; it is necessary to use the neuroimaging method, which makes it possible to determine the degree of the tumor spread and the peculiarities of its location relative to the chiasm. The absolute method of choice for treating giant pituitary adenomas is surgical; other methods are used in special cases or as an adjunct. There is no single algorithm for surgical strategy for managing this disease; this applies to tumors which size exceeds 4 cm in diameter.

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Endoscopic surgery of pituitary adenomas. Historical overview

Cited by 3 publications

References 44 publications

Endoscopic Cryosurgery

Endoscopic Cryosurgery

Ultrasound Doppler examination in the surgical treatment of pituitary adenomas with cavernous sinus extension

Giant pituitary adenomas, algorithm for selecting a treatment method: surgical, medical, radiological. Literature review

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