Resection of pituitary tumors: endoscopic versus microscopic

Singh, Harminder; Essayed, Walid Ibn; Cohen-Gadol, Aaron; Zada, Gabriel; Schwartz, Theodore H.

doi:10.1007/s11060-016-2124-y

Cited by 98 publications

(68 citation statements)

References 66 publications

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“…6) In a recent report by Dallapiazza et al 11) , microscopic and endoscopic techniques provided similar outcomes in the treatment of nonfunctioning adenomas with Knosp grades 0–2 (i.e. those without marked lateral extension).…”

Section: Introductionmentioning

confidence: 93%

“…Concerns about instrument maneuverability during endoscopic procedures have largely been alleviated with the development of newer endoscope-specific instrumentation and the evolution of endoscopic techniques. 6) A recent study by Elhadi et al 9) provided quantitative data on the superiority of the binarial endoscopic approach in achieving target surgical freedom and sagittal angular freedom. High definition 3D endoscopic system may resolve the stereoscopic visualization issue.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Recent Evolution of Endoscopic Endonasal Surgery for Treatment of Pituitary Adenomas

Nishioka

2017

Neurol. Med. Chir.(Tokyo)

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“…Recent studies have shown that endoscopic technique is better in terms of extent of tumor resection. 5,7,8 For smaller intrasellar tumors both techniques have been found equally good without much difference. However, for larger and parasellar tumors, endoscopic techniques have been found to be much helpful.…”

Section: Discussionmentioning

confidence: 97%

Pituitary Adenoma Surgery: Retrospective Analysis of My Personal Experience

Shrestha

Rajbhandari

2016

Nep J Neurosci

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Pituitary tumors are one of the common brain tumors after gliomas, meningieomas and acoustic schwaanomas. It is commonly encountered in Nepal also as in other countries.Retrospective case series analytical study was done. The cases of pituitary adenoma from 2009 till 2015 were included. Types of pituitary adenoma, surgical technique, postoperative morbidities, mortalities and outcome were analyzed.Total 21 cases of pituitary adenoma were operated. All the cases were diagnosed by MRI, plain and contrast. In addition, thorough hormonal evaluation was done. All the cases were operated via transnasal transsphenoidal (TSS) approach. Microscope was used in all the cases whereas endoscope was used in selected cases. Preoperative lumbar puncture and CSF drain was not done in any case.Postoperative transient nasal CSF leak and diabetes insipidus were the most common surgery related morbidities in almost 50% cases which were totally cured with time. All the patients became asymptomatic and got better after surgery. Postoperative mortality and long term morbidity were nil. Recurrence was noted in one case after 3 years of surgery.Pituitary tumor surgery is safe and rewarding provided it is done carefully with skilled hands. TSS is a good approach with minimal postoperative complications. Better to have both microscope and endoscope for TSS.

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“…Compared with the traditional microscope-based approach, the endoscopic approach provides better visualization, decreased invasiveness, and fewer complications, particularly for the removal of extrasellar and parasellar tumor extension [9,14]. The EEEA provides the possibility to resect the tumor with suprasellar extension, but at the same time, causes additional bone resection and more trauma than the standard surgery.…”

Section: Surgical Techniquementioning

confidence: 99%

“…In the 1960s, the operation microscope was introduced during transsphenoidal procedures by Hardy and was quickly adopted for clinical neurosurgical practice [8]. Since then, the use of a transsphenoidal microscope for pituitary surgery is considered the gold standard [9]. In 1963, Gerard Guito introduced the use of an endoscope during transsphenoidal procedures to provide an overview of the contents of the sellar turcica [10].…”

Section: Introductionmentioning

confidence: 99%