دورية أكاديمية
أعرض في EDS

Pituitary Tumor Surgery: Comparison of Endoscopic and Microscopic Techniques at a Single Center.

التفاصيل البيبلوغرافية
العنوان: Pituitary Tumor Surgery: Comparison of Endoscopic and Microscopic Techniques at a Single Center.
المؤلفون: Van Gompel JJ; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN. Electronic address: vangompel.jamie@mayo.edu., Atkinson JLD; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN., Choby G; Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN., Kasperbauer JL; Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN., Stokken JK; Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN., Janus JR; Department of Otorhinolaryngology, Mayo Clinic, Jacksonville, FL., O'Brien EK; Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN., Little JT; Department of Radiology, Mayo Clinic, Rochester, MN., Bancos I; Division of Endocrinology, Metabolism, Diabetes, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN., Davidge-Pitts CJ; Division of Endocrinology, Metabolism, Diabetes, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN., Ramachandran D; Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN., Herndon JS; Division of Endocrinology, Metabolism, Diabetes, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN., Erickson D; Division of Endocrinology, Metabolism, Diabetes, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN., Lanier WL; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
المصدر: Mayo Clinic proceedings [Mayo Clin Proc] 2021 Aug; Vol. 96 (8), pp. 2043-2057. Date of Electronic Publication: 2021 Jun 10.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: [Oxford, England] Country of Publication: England NLM ID: 0405543 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1942-5546 (Electronic) Linking ISSN: 00256196 NLM ISO Abbreviation: Mayo Clin Proc Subsets: MEDLINE
أسماء مطبوعة: Publication: Jan. 2012- : [Oxford, England] : Elsevier
Original Publication: Rochester, MN : Mayo Foundation for Medical Education and Research
مواضيع طبية MeSH: Endoscopy/*methods , Microsurgery/*methods , Pituitary Neoplasms/*surgery, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult
مستخلص: Objective: To understand the transition from microscopic surgery (MS) to endoscopic surgery (ES) on the pituitary across the United States, we assessed a single institution practicing both procedures to discern advantages and disadvantages for each.
Patients and Methods: Retrospective institutional chart review of 534 patients in a large practice over a 6-year period (January 1, 2014, to December 31, 2019) comparing a single MS neurosurgeon with a single ES neurosurgeon operating on the same days.
Results: In this series, 14% (n=75) of patients had a prior operation, there were no carotid artery injuries, the overall risk for a postoperative infection was 0.4% (n=2), and risk for a postoperative cerebrospinal fluid leak requiring treatment was 2.0% (n=11). Mean ± SD hospital stay was 1.3±0.04 days; readmission for any reason within 30 days occurred in 3.4% (n=18) of patients. The mean volumetric resection for MS was 86.9%±1.7% and for ES was 91.7%±1.3% (P=.03). There was a higher rate of notable events (P=.015) with MS, but MS had 16% lower cost and operative times were 48 minutes shorter than for ES (83±7 vs 131±6 minutes). The ES required substantially fewer postoperative secondary treatments such as radiation therapy (P=.003).
Conclusion: Pituitary surgery is a very safe and effective procedure regardless of technique. The MS has shorter operative times and overall lower cost. The ES results in increased volumetric resection and fewer secondary treatments. Both techniques can be valuable to a large practice, and understanding these niches is important when selecting optimal approaches to pituitary surgery for a given patient.
(Copyright © 2021 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: Mayo Clin Proc. 2021 Aug;96(8):2020-2021. (PMID: 34353462)
تواريخ الأحداث: Date Created: 20210614 Date Completed: 20210816 Latest Revision: 20210816
رمز التحديث: 20231215
DOI: 10.1016/j.mayocp.2021.03.028
PMID: 34120752
قاعدة البيانات: MEDLINE
الوصف
تدمد:1942-5546
DOI:10.1016/j.mayocp.2021.03.028