Multi‐institutional study of risk factors for perioperative morbidity following transnasal endoscopic pituitary adenoma surgery

Boling, Caitlin; Karnezis, Tom T.; Baker, Andrew B.; Lawrence, Lauren A.; Soler, Zachary M.; Vandergrift, William A.; Wise, Sarah K.; DelGaudio, John M.; Patel, Zara M.; Rereddy, Shruthi K.; Lee, John M.; Khan, Muhammad Zia; Govindaraj, Satish; Chan, Chun; Oue, Sakiko; Psaltis, Alkis J.; Wormald, Peter‐John; Trosman, Samuel J.; Stokken, Janalee K.; Woodard, Troy D.; Sindwani, Raj; Schlosser, Rodney J.

doi:10.1002/alr.21622

Cited by 54 publications

(89 citation statements)

References 26 publications

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“…retrospectively evaluated over 1000 patients with sellar lesions (craniopharyngioma and pituitary adenomas) from 7 different institutions and demonstrated a significantly higher postoperative CSF leak in patients with high BMI. A similar review of nearly 1000 patients with sellar lesions by Boling et al . similarly showed a significant increase in CSF leak rates with BMI >30.…”

Section: Complicationsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

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151

279

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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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Section: Complicationsmentioning

confidence: 99%

“…However, Karnezis et al . and Boling et al . demonstrated that a younger age was significantly associated with reconstructive failure, though their data set may have overlapped.…”

Section: Complicationsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

Self Cite

151

279

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“…In a multi-institutional study of risk factors for perioperative morbidity following endoscopic pituitary surgery reported by Boling et al 45) , adverse events including intracranial/systemic complications, reoperation, readmission, and death occurred in 23.8% of 982 patients. Most commonly, these events were readmission in 15.4% of cases and reoperation in 6.5% of cases.…”

Section: Complicationsmentioning

confidence: 99%

Recent Evolution of Endoscopic Endonasal Surgery for Treatment of Pituitary Adenomas

Nishioka

2017

Neurol. Med. Chir.(Tokyo)

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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. Despite many theoretical benefits in the endoscopic surgery, remission rates of functioning adenomas do not substantially differ between the approaches in experienced hands. The endoscopic approach is a valid alternative to the microscopic approach for adenomas. The benefits will be more appreciated in the extended surgery for parasellar tumors.

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“…CD must be distinguished from ectopic sources of ACTH; non-invasive tests have relatively low sensitivity and specificity 1 2. Because surgery carries significant morbidity,3 performing a minimally invasive procedure that is safe to demonstrate central-peripheral gradient and justify a risky surgical procedure is often an appropriate diagnostic step before resection.…”

Section: Introductionmentioning

confidence: 99%