Cirugía transnasal transesfenoidal endoscópica en afecciones de región selar
Transnasal-transsphenoidal endoscopic surgery of the sellar región
J.L. González-González
, O. López-Arbolay, O. Morales-Sabina, J.F. Martí-Piñeiro, R. Vidal-Verdial
Servicio de Neurocirugía. Hospital Hermanos Ameijeiras. Ciudad de la Habana. Cuba
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"apellidos" => "Lobato" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305704309?idApp=UINPBA00004B" "url" => "/11301473/0000001600000001/v1_201305151233/S1130147305704309/v1_201305151233/en/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Cirugía transnasal transesfenoidal endoscópica en afecciones de región selar" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "27" "paginaFinal" => "33" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.L. González-González, O. López-Arbolay, O. Morales-Sabina, J.F. Martí-Piñeiro, R. Vidal-Verdial" "autores" => array:5 [ 0 => array:3 [ "nombre" => "J.L." "apellidos" => "González-González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "O." "apellidos" => "López-Arbolay" ] 2 => array:2 [ "nombre" => "O." "apellidos" => "Morales-Sabina" ] 3 => array:2 [ "nombre" => "J.F." "apellidos" => "Martí-Piñeiro" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Vidal-Verdial" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Hermanos Ameijeiras. Ciudad de la Habana. Cuba" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital “Hermanos Ameijeiras” San Lázaro 701 Código Postal 10300. Centro Habana. Ciudad de la Habana. Cuba." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Transnasal-transsphenoidal endoscopic surgery of the sellar región" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-03-15" "fechaAceptado" => "2004-04-20" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158723" "palabras" => array:7 [ 0 => "Abordaje" 1 => "Adenomectomía" 2 => "Endoscópica" 3 => "Fístulas" 4 => "Macroadenomas" 5 => "Transnasal" 6 => "Transesfenoidal" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158722" "palabras" => array:5 [ 0 => "Approach" 1 => "Pituitary" 2 => "Endoscopic" 3 => "Transnasal" 4 => "Transsphenoidal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Para un gran número de tumores pituitarios la cirugía es el tratamiento de primera línea y el abordaje transesfenoidal microquirúrgico el más utilizado. En estos momentos, el mismo se ejecuta tanto por la vía sublabial como por la transnasal. Recientemente, el abordaje transnasal endoscópico ha irrumpido como una opción en desarrollo, que pudiera llegar a predominar en un futuro próximo.</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evaluar mediante el análisis de los resultados si es posible realizar en nuestro medio el abordaje transnasal transesfenoidal endoscópico para las lesiones de la región selar con resultados quirúrgicos, al menos, similares a los obtenidos con el método transesfenoidal tradicional.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Como fase I de un ensayo en 3 etapas se realiza una investigación limitada tipo cohorte, estrictamente controlada y prospectiva de 10 pacientes seleccionados según criterios de inclusión y a los cuales se les practicó el abordaje transnasal endoscópico como método de tratamiento quirúrgico entre Agosto del 2002 y Agosto del 2003 en el servicio de Neurocirugía del Hospital “Hermanos Ameijeiras”.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se operaron seis casos que tenían macroadenomas hipoflsarios, tres productores de GH, uno secretor de PRL y otros dos no productores. A los otros cuatro se les había diagnosticado fístula de LCR a través del piso selar. De los seis macroadenomas, en cinco se logró exéresis total del tumor, mientras que en el otro se obtuvo exéresis subtotal. La rinorrea desapareció en 2 pacientes con fístula de LCR y se mantuvo en los otros 2. De las complicaciones observadas en el 30% de los casos, solo en 1 (10%) transcendieron más allá del transoperatorio.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos en la fase 1 con la utilización del método transnasal endoscópico, hacen que el procedimiento en nuestro medió sea lo suficientemente seguro como para justificar el pase a la fase II del ensayo (aleatorizada y controlada), en busca de información más consistente, en relación al valor real de la técnica a estas alturas del desarrollo de la cirugía hipofisaria.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Transnasal transsphenoidal endoscopic approach to the sella turcica has recently become an option to the pituitary surgery which could predomínate in a near future.</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To evalúate through the analysis of our results whether it is possible to perform in our Hospital the endoscopic transnasal transsphenoidal approach to the sella with results at least as good as those we obtain with the microscopic sublabial transseptal transsphenoidal approach.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">As the first stage of a three stage randomized trial, this is a prospective study of 10 patients operated on, using transnasal transsphenoidal endoscopic aproach between august 2002 and August 2003 at the department of neurosurgery of “Hermanos Ameijeiras Hospital”.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Six patients had pituitary macroadenomas and four had cerebrospinal fluid leak through the sellar floor. In five of six macroadenomas total tumor resection was obtained and in the other one a subtotal resection was performed. Two of four patients with cerebrospinal fluid leak could be cured while the other two patients do not. Complications were present in 30% of cases, but in only 1 (10%) it reached the postoperatory period.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Transnasal transsphenoidal endoscopic approach to the sella can be done save enough in our Hospital to justify the start of the second stage of one randomized trial to determine if the endoscopic techni-que is better than the usual transsphenoidal approach.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">González-González, J.L.; López-Arbolay, O.; Morales-Sabina, O.; Martí-Piñeiro, J.F.; Vidal-Verdial R.: Cirugía transnasal transesfenoidal endoscópica en afecciones de región selar. Neurocirugía 2005; 16: 27–23.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pituitary adenoma in Olmsted County, Minnesota, 1935–1977: a report of an increasing incidente of diagnosis in women o fchildbearing age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.F. Annegers" 1 => "C.B. Coulam" 2 => "C.E. Abboud" 3 => "E.R. Laws Jr." 4 => "L.T. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 1 | 1 | 2 |
| 2023 Febrero | 0 | 1 | 1 |
| 2018 Febrero | 15 | 6 | 21 |
| 2018 Enero | 20 | 6 | 26 |
| 2017 Diciembre | 13 | 9 | 22 |
| 2017 Noviembre | 22 | 8 | 30 |
| 2017 Octubre | 22 | 8 | 30 |
| 2017 Septiembre | 18 | 13 | 31 |
| 2017 Agosto | 25 | 10 | 35 |
| 2017 Julio | 23 | 4 | 27 |
| 2017 Junio | 35 | 5 | 40 |
| 2017 Mayo | 31 | 10 | 41 |
| 2017 Abril | 36 | 7 | 43 |
| 2017 Marzo | 14 | 7 | 21 |
| 2017 Febrero | 23 | 5 | 28 |
| 2017 Enero | 24 | 6 | 30 |
| 2016 Diciembre | 39 | 19 | 58 |
| 2016 Noviembre | 54 | 8 | 62 |
| 2016 Octubre | 44 | 18 | 62 |
| 2016 Septiembre | 63 | 16 | 79 |
| 2016 Agosto | 68 | 19 | 87 |
| 2016 Julio | 38 | 22 | 60 |
| 2016 Marzo | 1 | 0 | 1 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Julio | 4 | 6 | 10 |
| 2015 Junio | 28 | 12 | 40 |
| 2015 Mayo | 31 | 23 | 54 |
| 2015 Abril | 20 | 25 | 45 |
| 2015 Marzo | 22 | 20 | 42 |
| 2015 Febrero | 17 | 24 | 41 |
| 2015 Enero | 22 | 15 | 37 |
| 2014 Diciembre | 21 | 21 | 42 |
| 2014 Noviembre | 18 | 17 | 35 |
| 2014 Octubre | 27 | 32 | 59 |
| 2014 Septiembre | 19 | 21 | 40 |
| 2014 Agosto | 11 | 23 | 34 |
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| 2014 Junio | 26 | 29 | 55 |
| 2014 Mayo | 24 | 25 | 49 |
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| 2014 Marzo | 20 | 31 | 51 |
| 2014 Febrero | 25 | 23 | 48 |
| 2014 Enero | 15 | 24 | 39 |
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| 2013 Octubre | 24 | 24 | 48 |
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