Evaluation of Outcomes After Endoscopic Endonasal Surgery for Large and Giant Pituitary Macroadenoma: A Retrospective Review of 39 Consecutive Patients

Chabot, J; Chakraborty, Shamik; Imbarrato, Gregory; Dehdashti, Amir R.

doi:10.1016/j.wneu.2015.06.007

Cited by 76 publications

(63 citation statements)

References 42 publications

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“…It is worth emphasizing that only one purely endoscopic surgical series was included in their analysis, since the manuscript by de Paiva Neto et al 24 was mainly microscopic transphenoidal. Thereafter, few studies came out in the literature addressing the outcomes of patients undergoing resection for large and giant pituitary adenomas by the endoscopic approach 6,8,10,11,13,14,15,16 . Their main surgical outcomes and complications rates are detailed on Tables 3 and 4 …”

Section: Discussionmentioning

confidence: 99%

“…As aforementioned, GTR is not the goal for such large tumors because of neurovascular structures involvement and the recent success of adjuvant therapies 8 . Thus, the extent of resection is difficult to evaluate as an outcome for large and giant pituitary adenomas 8 .…”

Section: Extent Of Resection Of the Endoscopic Endonasal Transsphenoimentioning

confidence: 99%

“…Thus, the extent of resection is difficult to evaluate as an outcome for large and giant pituitary adenomas 8 . Moreover, there is no general consensus on the definition for near total (NTR), subtotal (STR), and partial resection (PR), as also noted by Chabot et al 8 .…”

Section: Extent Of Resection Of the Endoscopic Endonasal Transsphenoimentioning

confidence: 99%

“…The definition is based on a purely morphological criterion in the way that when the tumor achieves a diameter greater than 4 cm in any plane, it is considered giant 5,6,7 . There is no consensus, however, on the definition of large pituitary adenomas 8,9 . Juraschka et al 10 have considered large tumors as those having > 3 cm in the maximal diameter, while Cusimano et al 11 have introduced a new volumetric assessment (≥ 10 cm 3 ) on the assumption of a better estimation of the tumor size and also for a better quantification of the extent of resection.…”

mentioning

confidence: 99%

“…Some recent reports have described the usefulness of the endoscopic endonasal route in the their management, even though its safety and effectiveness of treating large and giant pituitary adenomas is yet to be established in the literature 6,8,10,11,13,14,15,16 . Herein, we sought to investigate our institutional experience of patients who underwent endoscopic endonasal transsphenoidal approach for treatment of large and giant pituitary adenomas emphasizing the surgical results and approachrelated complications.…”

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confidence: 99%

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Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications

Constantino

Leal

Ferreira

et al. 2016

Arq. Neuro-Psiquiatr.

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Objective: In this study, we investigate our institutional experience of patients who underwent endoscopic endonasal transsphenoidal approach for treatment of large and giant pituitary adenomas emphasizing the surgical results and approach-related complications. Method: The authors reviewed 28 consecutive patients who underwent surgery between March, 2010 and March, 2014. Results: The mean preoperative tumor diameter was 4.6 cm. Gross-total resection was achieved in 14.3%, near-total in 10.7%, subtotal in 39.3%, and partial in 35.7%. Nine patients experienced improvement in visual acuity, while one patient worsened. The most common complications were transient diabetes insipidus (53%), new pituitary deficit (35.7%), endonasal adhesions (21.4%), and cerebrospinal fluid leak (17.8%). Surgical mortality was 7.1%. Conclusions: Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for large or giant pituitary adenomas, which results in high rates of surgical decompression of cerebrovascular structures.Keywords: endoscopic endonasal approach; giant pituitary adenomas; large pituitary adenomas; complication rates. RESUMOObjetivo: Neste manuscrito investigamos a experiência institucional com o acesso endonasal endoscópico transesfenoidal no tratamento de adenomas hipofisários grandes e gigantes com ênfase às complicações relacionadas ao acesso cirúrgico. Método: Foram incluídos neste estudo 28 pacientes consecutivos submetidos à cirurgia entre Março de 2010 e Março de 2014. Resultados: O diâmetro médio pré-operatório dos tumores era 4,6 cm. Uma ressecção total foi obtida em 14,3%; quase total, em 10,7%; subtotal, em 39,3% e parcial, em 35,7%. Nove pacientes evoluíram com melhora na acuidade visual, enquanto um paciente apresentou piora da função visual. As complicações mais comuns foram diabetes insipidus transitório (53%), novo défice hipofisário (35,7%), sinéquias endonasais (21,4%) e fistula liquórica (17,8%). A mortalidade cirúrgica foi 7,1%. Conclusões: A cirurgia por via endonasal endoscópica transesfenoidal é uma opção terapêutica extremamente útil para adenomas hipofisários grandes e gigantes, a resultar numa significativa descompressão das estruturas cerebrovasculares.Palavras-chave: acesso endoscópico endonasal; adenoma hipofisário gigante; adenoma hipofisário grande; índices de complicação.

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Section: Discussionmentioning

confidence: 99%

Section: Extent Of Resection Of the Endoscopic Endonasal Transsphenoimentioning

confidence: 99%

Section: Extent Of Resection Of the Endoscopic Endonasal Transsphenoimentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications

Constantino

Leal

Ferreira

et al. 2016

Arq. Neuro-Psiquiatr.

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

137

260

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Histone deacetylase 11 suppresses p53 expression in pituitary tumor cells

Wang

Li³

et al. 2017

Cell Biology International

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The pathogenesis of pituitary tumors (PT) is unclear. Deregulation of apoptosis is one of the factors involving tumor growth. Histone deacetylases (HDAC) have an active role in multiple cellular activities. This study aims to investigate the role of HDAC in the interference with apoptosis in PT. In this study, PT samples were collected from 20 patients after surgery. The expression of HDAC and p53 was analyzed in the PT samples. PT cell line, AtT-20 cells, was cultured to test the role of HDAC in the regulation of apoptosis in PT cells. The results showed that the high levels of HDAC11 and lower levels of p53 were detected in PT. A negative correlation was detected between the data of HDAC11 and p53. A complex of HDAC11 and HEY1, the gene transcription factor of p53, was detected in the PT cells. Less acetylated HEY1 was found in the PT cells. In addition, lower levels of HEY1 and the gene transcription activities were detected at the PT53 promoter locus. This phenomenon was mimicked by overexpression of HDAC11 in AtT-20 cells. Knockdown of HDAC11 enhanced the p53 expression in AtT-20 cells. In conclusion, HDAC11 interferes with p53 expression in PT cells. The fact suggests that inhibition of HDAC11 has therapeutic potential in the treatment of PT.

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Evaluation of Outcomes After Endoscopic Endonasal Surgery for Large and Giant Pituitary Macroadenoma: A Retrospective Review of 39 Consecutive Patients

Cited by 76 publications

References 42 publications

Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications

Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications

ICAR: endoscopic skull‐base surgery

Histone deacetylase 11 suppresses p53 expression in pituitary tumor cells

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