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Titolo:
Surgical treatment of craniopharyngiomas: endocrinological results
Autore:
Honegger, J; Buchfelder, M; Fahlbusch, R;
Indirizzi:
Univ Erlangen Nurnberg, Dept Neurosurg, D-91054 Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany D-91054 -91054 Erlangen, Germany
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 2, volume: 90, anno: 1999,
pagine: 251 - 257
SICI:
0022-3085(199902)90:2<251:STOCER>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHILDHOOD CRANIOPHARYNGIOMA; ENDOCRINE SEQUELAE; MANAGEMENT; RADIATION; SURGERY; REMOVAL;
Keywords:
craniopharyngioma; hypopituitarism; diabetes insipidus; pituitary stalk; surgical approach;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Fahlbusch, R Univ1054angen Nurnberg, Dept Neurosurg, Schwabachanlage 6 Kopfklinikum, D-9 Univ Erlangen Nurnberg Schwabachanlage 6 Kopfklinikum Erlangen Germany D-91054
Citazione:
J. Honegger et al., "Surgical treatment of craniopharyngiomas: endocrinological results", J NEUROSURG, 90(2), 1999, pp. 251-257

Abstract

Object. This study aimed to elucidate the endocrinological outcome of craniopharyngioma surgery. In particular, endocrinological results were analyzed in relation to the surgical approach. The study includes 143 patients whounderwent pre- and postoperative endocrinological assessment and who had not previously undergone surgery. Methods. Diabetes insipidus was the most common postoperative deficiency in both the transcranial and transsphenoidal groups. The overall percentage of patients with diabetes insipidus increased from 16.1% preoperatively to 59.4% postoperatively. After transcranial surgery, the rate of anterior pituitary deficiency also increased. However, normal preoperative anterior pituitary function was maintained in more than 50% of patients for each endocrine axis. Similar results were attained in the group of patients undergoingcomplete tumor removal. The best result was achieved for gonadal function:the incidence of hypogonadism increased only slightly from 77.4 to 79.8%. The rate of anterior pituitary failure at presentation was much higher in the transsphenoidal than in the transcranial group. During transsphenoidal surgery, intact anterior pituitary functions were generally preserved. The rate of panhypopituitarism increased only slightly, from 40% before surgery to 42.9% after surgery. Endocrinological results were not inferior in patients with a ventrally displaced pituitary. This variant required midline incision of the gland for exposure of the craniopharyngioma. In the entire series of 143 patients the pituitary stalk was generally preserved. Postoperative panhypopituitarism was encountered in only one of eight patients in whom the pituitary stalk was partially resected because of tumor infiltration. None of the 88 patients who remained recurrence-free demonstrated endocrinological deterioration during follow-up review, compared with the early postoperative assessment 3 months postsurgery. On the other hand, complete recovery of one endocrine axis was observed in nine of these patients during later follow-up evaluations. In five of them, diabetes insipidus had regressed. Conclusions. It is worth preserving the pituitary stalk and gland at surgery because of the definite chance that intact anterior pituitary functions can be maintained. Postoperative diabetes insipidus must be accepted as a common sequela following attempts at complete removal of the craniopharyngioma.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 07:53:34