The Results of Surgical Treatment of Cushing Tumors in the Republic of Uzbekistan: Establishing Transsphenoidal Surgery in A Developing Nation

Powell, Michael; Narimova, G.J.; Halimova, Zamira J.

doi:10.1016/j.wneu.2016.09.067

Cited by 4 publications

(1 citation statement)

References 22 publications

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“…Pharmaceutical and medicinal chemistry has transformed the materials of everyday life, but this is merely a quick look of the future of pharmaceutical and medicinal materials such as intelligent molecules that behave as a sensor, self-reproducing pharmaceutical and medicinal compounds, molecules that work (Nano-Engineering) and even molecules that think may transform our world in ways not yet imagined [1][2][3][4][5][6]. These developments are the result of cooperation among pharmaceutical chemists, physicists, engineers, material scientists, computer experts, pharmacists, medicinal chemists and many others.…”

Section: Opinionmentioning

confidence: 99%

Changing Metal Powder Characteristics for Elimination of the Heavy Metals Toxicity and Diseases in Disruption of Extracellular Matrix (ECM) Proteins Adjustment in Cancer Metastases Induced by Osteosarcoma, Chondrosarcoma, Carcinoid, Carcinoma, Ewing’ s Sarcoma, Fibrosarcoma and Secondary Hematopoietic Solid or Soft Tissue Tumors

Heidari¹

2017

J Powder Metall Min

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Section: Opinionmentioning

confidence: 99%

Changing Metal Powder Characteristics for Elimination of the Heavy Metals Toxicity and Diseases in Disruption of Extracellular Matrix (ECM) Proteins Adjustment in Cancer Metastases Induced by Osteosarcoma, Chondrosarcoma, Carcinoid, Carcinoma, Ewing’ s Sarcoma, Fibrosarcoma and Secondary Hematopoietic Solid or Soft Tissue Tumors

Heidari¹

2017

J Powder Metall Min

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Endoscopic vs. microscopic transsphenoidal surgery for Cushing’s disease: a systematic review and meta-analysis

et al. 2018

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PurposeSystematic review and meta-analysis comparing endoscopic and microscopic transsphenoidal surgery for Cushing’s disease regarding surgical outcomes (remission, recurrence, and mortality) and complication rates. To stratify the results by tumor size.MethodsNine electronic databases were searched in February 2017 to identify potentially relevant articles. Cohort studies assessing surgical outcomes or complication rates after endoscopic or microscopic transsphenoidal surgery for Cushing’s disease were eligible. Pooled proportions were reported including 95% confidence intervals.ResultsWe included 97 articles with 6695 patients in total (5711 microscopically and 984 endoscopically operated). Overall, remission was achieved in 5177 patients (80%), with no clear difference between both techniques. Recurrence was around 10% and short term mortality < 0.5% for both techniques. Cerebrospinal fluid leak occurred more often in endoscopic surgery (12.9 vs. 4.0%), whereas transient diabetes insipidus occurred less often (11.3 vs. 21.7%). For microadenomas, results were comparable between both techniques. For macroadenomas, the percentage of patients in remission was higher after endoscopic surgery (76.3 vs. 59.9%), and the percentage recurrence lower after endoscopic surgery (1.5 vs. 17.0%).ConclusionsEndoscopic surgery for patients with Cushing’s disease reaches comparable results for microadenomas, and probably better results for macroadenomas than microscopic surgery. This is present despite the presumed learning curve of the newer endoscopic technique, although confounding cannot be excluded. Based on this study, endoscopic surgery may thus be considered the current standard of care. Microscopic surgery can be used based on neurosurgeon’s preference. Endocrinologists and neurosurgeons in pituitary centers performing the microscopic technique should at least consider referring Cushing’s disease patients with a macroadenoma.Electronic supplementary materialThe online version of this article (10.1007/s11102-018-0893-3) contains supplementary material, which is available to authorized users.

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The experience with transsphenoidal surgery and its importance to outcomes

Honegger

Grimm

2018

Pituitary

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We conclude that a center with experience of > 25 transsphenoidal operations for pituitary adenomas per year provides a high likelihood of safe TSS. Surgery for CD requires a particularly high level of practice to guarantee excellent remission rates. The endocrinologist has the unique opportunity to audit the surgical success by hormone measurement and to refer patients to neurosurgeons with proven excellence.

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The Results of Surgical Treatment of Cushing Tumors in the Republic of Uzbekistan: Establishing Transsphenoidal Surgery in A Developing Nation

Cited by 4 publications

References 22 publications

Endoscopic vs. microscopic transsphenoidal surgery for Cushing’s disease: a systematic review and meta-analysis

The experience with transsphenoidal surgery and its importance to outcomes

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