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Titolo:
ENDOSCOPIC PITUITARY SURGERY - AN EARLY EXPERIENCE
Autore:
JHO HD; CARRAU RL; KO Y; DALY MA;
Indirizzi:
PRESBYTERIAN UNIV HOSP,DEPT NEUROL SURG,SUITE B-400,200 LOTHROP ST PITTSBURGH PA 15213 UNIV PITTSBURGH,SCH MED,DEPT NEUROL SURG PITTSBURGH PA 15261 UNIV PITTSBURGH,SCH MED,DEPT OTOLARYNGOL PITTSBURGH PA 15261 UNIV PITTSBURGH,SCH MED,DIV ENDOCRINOL PITTSBURGH PA 15261
Titolo Testata:
Surgical neurology
fascicolo: 3, volume: 47, anno: 1997,
pagine: 213 - 222
SICI:
0090-3019(1997)47:3<213:EPS-AE>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
TUMOR SURGERY;
Keywords:
CUSHINGS DISEASE; ENDOSCOPY; PITUITARY NEOPLASMS; PROLACTINOMA; SPHENOID SINUS; TRANSSPHENOIDAL APPROACH;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
H.D. Jho et al., "ENDOSCOPIC PITUITARY SURGERY - AN EARLY EXPERIENCE", Surgical neurology, 47(3), 1997, pp. 213-222

Abstract

BACKGROUND As an element of a minimally invasive management approach,we had developed an endonasal endoscopic transsphenoidal technique for the treatment of pituitary tumors. Initially, four patients were operated on via a sublabial, transseptal approach using a fiberoptic rigid endoscope in conjunction with the operating microscope. Encouraged by that experience, our subsequent 11 patients had undergone endonasal endoscopic transsphenoidal surgery without the use of a retractor or speculum. METHODS Our group of patients included nine females and six males, with an age range of 17-88 years (median: 43 years). There were four microadenomas, four intrasellar macroadenomas, three macroadenomas with suprasellar extension, three invasive macroadenomas involving the cavernous sinus with suprasellar extension, and one metastatic adenocarcinoma. RESULTS Thirteen patients with pituitary adenomas experienced resolution of their symptoms postoperatively. One patient with a recurrent prolactinoma responded partially following surgery and subsequently underwent gamma knife radiosurgery. Two patients were treated with post-operative fractionated radiation therapy,on pituitary adenomain the cavernous sinus, and the other for metastatic adenocarcinoma, respectively. The first patient, treated via an endonasal endoscopic approach for biopsy of the metastatic adenocarcinoma, developed postoperative cerebrospinal fluid (CSF) leak that was successfully managed with endoscopic packing of a fat graft. CONCLUSIONS The endonasal endoscopic transsphenoidal approach facilitates faster postoperative recovery by the avoidance of traditional incision and postoperative nasal packing. It offers a panoramic view of the sphenoid sinus and excellent visualization of the sellar and suprasellar structures with increased illumination and magnification. Such visualization provides the potential for more complete tumor resection, as well as a better chance of preserving pituitary function and avoiding neurovascular injury. (C) 1997 by Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 19:50:23