Surgical Results of Pure Endoscopic Endonasal Transsphenoidal Surgery for 331 Pituitary Adenomas: A 15-Year Experience from a Single Institution

Jang, Ji Hwan; Kim, Kyu Hong; Lee, Young Min; Kim, Joon Soo; Kim, Young Zoon

doi:10.1016/j.wneu.2016.09.051

Cited by 54 publications

(42 citation statements)

References 21 publications

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“…Both endoscopic endonasal and microscopic transsphenoidal approaches are recommended for symptom relief in patients with NFPAs [22]. Endoscopic endonasal surgery allows better visualization of areas of difficult access and larger tumor resections, and according some authors, it offers better surgical outcomes and lower complication rate [23], [24], [25], [26]. In our series remission rate ranged from 20% for transfrontal surgery to 36% for endoscopic endonasal surgery.…”

Section: Discussionmentioning

confidence: 63%

Non-functioning pituitary adenoma underwent surgery: A multicenter retrospective study over the last four decades (1977–2015)

Iglesias

Arcano

Triviño

et al. 2017

European Journal of Internal Medicine

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Section: Discussionmentioning

confidence: 63%

Non-functioning pituitary adenoma underwent surgery: A multicenter retrospective study over the last four decades (1977–2015)

Iglesias

Arcano

Triviño

et al. 2017

European Journal of Internal Medicine

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“…Eight studies investigated the potential risk factors for complications in general [ 17 , 19 , 20 , 22 , 28 , 30 , 31 , 35 ]. Incidence rates of complications in general were often not given.…”

Section: Resultsmentioning

confidence: 99%

“…Both studies found an increased risk for older age (35,36). Age was defined as a categorical parameter: (1) age ≥70 versus <60 years (32.7 vs. 10%, p < 0.05) [ 30 ] and (2) age ≥50 years versus <50 OR 2.75 (95% CI 1.18–4.32, multivariate) [ 31 ]. This shows an increased risk for higher age.…”

Section: Resultsmentioning

confidence: 99%

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Preoperative risk factors for postoperative complications in endoscopic pituitary surgery: a systematic review

et al. 2017

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BackgroundThe ability to preoperatively predict postoperative complication risks is valuable for individual counseling and (post)operative planning, e.g. to select low-risk patients eligible for short stay surgery or those with higher risks requiring special attention. These risks however, are not well established in pituitary surgery.MethodsWe conducted a systematic review of associations between preoperative characteristics and postoperative complications of endoscopic transsphenoidal surgery according to the PRISMA guidelines. Risk of bias was assessed through the QUIPS tool.ResultsIn total 23 articles were included, containing 5491 patients (96% pituitary adenoma). There was a wide variety regarding the nature and number of risk factors, definitions, measurement and statistics employed, and overall quality of mainly retrospective studies was low. Consistent significant associations were older age for complications in general, and intraventricular extension for cerebrospinal fluid (CSF) leaks. Associations identified in some but not all studies were younger age, increased BMI, female gender, and learning curve for CSF leaks; increased tumor size for complications in general; and Rathke’s cleft cysts for diabetes insipidus. Mortality (incidence rate 1%) was not addressed as a risk factor.ConclusionBased on current literature, of low to medium quality, it is not possible to comprehensively quantify risk factors for complications. Nevertheless, older age and intraventricular extension were associated with increased postoperative complications. Future research should aim at prospective data collection, reporting of outcomes, and uniformity of definitions. Only then a proper risk analysis can be performed for endoscopic pituitary surgery.Electronic supplementary materialThe online version of this article (doi:10.1007/s11102-017-0839-1) contains supplementary material, which is available to authorized users.

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“…Overall postoperative CSF leak and bacterial meningitis rates in 9 recent large endoscopic pituitary adenoma series (all with over 200 patients) have ranged from 0.6% to 5%, and 0% to 3.4%, respectively. NSF usage in these series ranges from 1% to 43% and planned lumbar CSF drainage from 0.6% to 21.7% …”

Section: Intradural Tumorsmentioning

confidence: 97%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

143

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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Surgical Results of Pure Endoscopic Endonasal Transsphenoidal Surgery for 331 Pituitary Adenomas: A 15-Year Experience from a Single Institution

Cited by 54 publications

References 21 publications

Non-functioning pituitary adenoma underwent surgery: A multicenter retrospective study over the last four decades (1977–2015)

Non-functioning pituitary adenoma underwent surgery: A multicenter retrospective study over the last four decades (1977–2015)

Preoperative risk factors for postoperative complications in endoscopic pituitary surgery: a systematic review

ICAR: endoscopic skull‐base surgery

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