Publish in this journal
Journal Information
Vol. 28. Num. 2.March - April 2017Pages 51-102
Share
Share
Download PDF
More article options
Visits
3
Vol. 28. Num. 2.March - April 2017Pages 51-102
Clinical Research
DOI: 10.1016/j.neucie.2016.12.001
Endoscopic treatment of 140 pituitary tumors, results and complications
Tratamiento endosc??pico de 140 tumores de hip??fisis, resultados y complicaciones
Sofia Beltramea, Maximiliano Toscanoa, Ezequiel Goldschmidtb, Lucas Garateguia, Alvaro Camperoc, Claudio Yampolskya, Antonio Carrizoa, Pablo Ajlera,
Corresponding author
a Servicio de Neurocirug??a, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
b Department of Neurological Surgery, University of Pittsburgh, PA, USA
c Servicio de Neurocirug??a, Hospital Padilla, Tucum??n, Argentina
Visits
3
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (3)
Table 1. Distribution of the grade of resection according to hormonal production, size and invasion of the cavernous sinus.
Table 2. Hormonal control according to the pathology. Cases with invasion of the cavernous sinus and cases with Ki-67 greater or equal to 3% are also described.
Table 3. Distribution of complications according to the pituitary pathology.
Show moreShow less
Abstract
Objective

To present the clinical and radiographic outcomes of 140 patients with pituitary adenomas treated by an endoscopic endonasal approach (EEA) over a period of 4 years.

Material and methods

A retrospective analysis was performed between 2011 and 2014. Pre and post operative MRI, ophtalmological assessment, endocrinological laboratory evaluation and surgical morbidity and mortality were assessed.

Results

57.9% of the patients had functional tumours (n=81), acromegaly being the most frequent sub-type (29.3%). 78.6% of the lesions were macroadenomas (n=110) of which 56.4% (n=62) involved the cavernous sinus, 61 patients presented with visual field defects (44%) of which 50.8% of patients showed improvement after surgery. Gross total removal was achieved in 60% of the cases. Hormonal remission was achieved in the 75% of the patients with functional tumours. The morbidity rate was 15% and one patient died after surgery (mortality 0.7%).

Conclusion

EEA is a safe and effective tool to treat pituitary adenomas. The main limitation for complete surgical resection is the cavernous sinus invasion.

Keywords:
Pituitary adenomas
Transnasal
Endoscopy
Resumen
Objetivo

Presentar los resultados y las complicaciones de 140 pacientes con adenomas hipofisarios operados por vía transnasal endoscópica en un período de 4 años.

Material y métodos

Se realizó un análisis retrospectivo desde marzo del 2011 hasta diciembre del 2014. Se analizaron las imágenes, los estudios oftalmológicos y hormonales, tanto pre como postoperatorios, así como también la morbimortalidad asociada al procedimiento quirúrgico.

Resultados

Se registró un 57,9% de pacientes con tumores funcionantes (n=81), siendo la patología más frecuente la acromegalia (29,3%). El 78,6% fueron macroadenomas (n=110), de los cuales el 56,4% (n=62) presentaban invasión del seno cavernoso; 61 presentaron alteración en el campo visual computarizado (44%). Tras la intervención, el 50,8% de los pacientes obtuvo mejoría. En un 60% de los casos se alcanzó una resección completa. De los pacientes con patología funcionante (81 casos), un 25% persistió con enfermedad activa tras la cirugía. Se registró un 15% de pacientes complicados (n=21) y un solo fallecimiento (0,7%).

Conclusión

Según los resultados obtenidos, esta técnica presenta baja morbimortalidad y elevado éxito terapéutico. La principal limitante para la resección quirúrgica completa es la invasión del seno cavernoso.

Palabras clave:
Adenomas de hip??fisis
Transnasal
Endoscopia

Article

You can access the full contents of Neurocirugía (English edition) by becoming a subscriber or a member of the Sociedad Española de Neurocirugía
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

Subscriber
Subscriber

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Neurocirugía (English edition)

Subscribe to our Newsletter

Article options
Tools
Cookies policy
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.