Endoscopic endonasal approach for pituitary adenomas: a series of 555 patients

Abstract

The EEA is a safe and effective way to surgically approach pituitary adenomas, particularly in recurrent tumors, those with supra-sellar extension or cavernous sinus invasion. The remission and complication rates are comparable or favorable compared with those reported in previous series of microscopic and endoscopic approaches.

THERAPY OF ENDOCRINE DISEASE: Surgery in microprolactinomas: effectiveness and risks based on contemporary literature

“…Series reporting the outcomes of endoscopic transsphenoidal surgery in microprolactinomas are rather limited ( Table 2). The postoperative remission rates range between 81 and 100%, and in all but one of the studies, there is no available information on previous DA administration (19,28,29,30,31,32,33,34,35). Given that the main advantages of the endoscopic approach involve invasive adenomas, it would be anticipated that the remission rates should not differ between microscopic and endoscopic techniques in microprolactinomas.…”

Pituitary macroadenoma: analysis of intercarotid artery distance compared to controls

“…In the transsphenoidal approach for pituitary adenomas, detailed preoperative planning with information regarding the sphenoid sinus, tumoral involvement of adjacent structures (cavernous sinus, suprasellar region, carotid arteries) and intercarotid distance (ICD) is critical. Despite that, there is little literature regarding the ICD at the parassellar region of the intracranial carotid arteries at its cavernous segment and its modifications due to the sellar pathologies, specially non-functioning pituitary adenomas 2,3,4,5,6 .Although vascular injuries have become less frequent over the years, with reports ranging from 0-3.8% 7,8,9,10,11,12,13,14,15,16,17,18,19,20 , it is still considered one of the most important complications in the transsphenoidal approaches due to its potential hazardous effects and difficult management. Taking this into consideration, it is crucial that every surgeon knows exactly the carotid artery position and its relation to the lesion.…”

“…Although vascular injuries have become less frequent over the years, with reports ranging from 0-3.8% 7,8,9,10,11,12,13,14,15,16,17,18,19,20 , it is still considered one of the most important complications in the transsphenoidal approaches due to its potential hazardous effects and difficult management. Taking this into consideration, it is crucial that every surgeon knows exactly the carotid artery position and its relation to the lesion.…”

Cirugía endoscópica endonasal en patología selar. Análisis de nuestros primeros 200 pacientes. Qué hemos aprendido

“…La edad media de la muestra es de 51,7 años (rango: 18-82 años), con un seguimiento medio de 4,74 años (rango 0, [5][6][7][8]9). …”

“…Paluzzi et al 9 presentan una serie de 555 pacientes operados mediante cirugía EET, de los cuales 237 presentaban alteraciones visuales; observaron mejoría o remisión del déficit en el 80,2% de los pacientes, mientras que el 17,3% no presentaron cambios y el 1,7% empeoraron. Estos resultados comprenden un espectro en el que podríamos incluir los de nuestra serie: mejoría del déficit visual en el 70% de los pacientes afectados y una estabilización de los síntomas en el 25% de los pacientes.…”