Morten Winkler Møller
Morten Winkler Møller
Department of Neurosurgery, Odense University Hospital, Odense C, Denmark
Clinical Institute, University of Southern Denmark, Odense C, Denmark
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Clinical Institute, University of Southern Denmark, Odense C, Denmark
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Marianne Skovsager Andersen
Marianne Skovsager Andersen
Clinical Institute, University of Southern Denmark, Odense C, Denmark
Department of Endocrinology, Odense University Hospital, Odense C, Denmark
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Department of Endocrinology, Odense University Hospital, Odense C, Denmark
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Christian Bonde Pedersen
Christian Bonde Pedersen
Department of Neurosurgery, Odense University Hospital, Odense C, Denmark
Clinical Institute, University of Southern Denmark, Odense C, Denmark
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Clinical Institute, University of Southern Denmark, Odense C, Denmark
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Bjarne Winther Kristensen
Bjarne Winther Kristensen
Clinical Institute, University of Southern Denmark, Odense C, Denmark
Department of Pathology, Odense University Hospital, Odense C, Denmark
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Department of Pathology, Odense University Hospital, Odense C, Denmark
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Frantz Rom Poulsen
Frantz Rom Poulsen
Department of Neurosurgery, Odense University Hospital, Odense C, Denmark
Clinical Institute, University of Southern Denmark, Odense C, Denmark
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Clinical Institute, University of Southern Denmark, Odense C, Denmark
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Background
Intraoperative low field MRI (iMRI, 0.15 T) during transsphenoidal surgery on pituitary adenomas (PAs) may significantly improve tumor removal. However, extensive surgery can lead to pituitary hormone deficiency. Furthermore, introduction of iMRI will prolong duration of surgery, which may elevate risk of postoperative infections.
Methods
Overall, 180 transsphenoidal surgeries for PAs from 2007 to 2015 were included. IMRI was available from 2011 to 2015, during this period 67/78 (86%) surgeries were with iMRI (iMRI, n = 67). A total of 113 surgeries were performed without iMRI (controls). All surgical procedures were performed by microscopic technique. Tumor size, hormonal status and vision were assessed before surgery and 3–5 months postoperatively.
Results
Gross total resection (GTR), mean tumor remnant volume and ∆-volumes were comparable between iMRI and controls: 15% (10/66) vs 23% (26/109) (P = 0.17), 2.97 cm3 (0.9–5) vs 2.1 cm3 (1.6–2.6) (P = 0.3) and 4.5 cm3 (3.6–5.5) vs 5.1 cm3 (4.2–6) (P = 0.4), respectively. Duration of surgery was significantly longer during iMRI vs controls: 126 min (117–135) vs 98 min (92–103) (P < 0.001). New pituitary–adrenal deficiency in iMRI vs controls was seen in 35% (17/48) and 35% (23/66) of surgeries, respectively (P = 0.95). New thyroid deficiency was found in 33% (13/29) and 41% (28/69) and visual field deficiencies improved in 44% (19/43) and 38% (23/60) in iMRI vs controls, respectively (P > 0.1).
Conclusion
Tumor remnant after pituitary surgery was not significantly reduced using intraoperative low field MRI. Duration of surgery was increased in iMRI, but was not associated with increased infection rate. Pituitary hormonal function and vision were comparable between iMRI and controls.
Nidan Qiao
Nidan Qiao
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
Harvard Medical School, Boston, Massachusetts, USA
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Harvard Medical School, Boston, Massachusetts, USA
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to these advantages, increasing numbers of neurosurgeons have started to adopt the endoscopic technique in recent years. Compared with microscopic surgery, endoscopic transsphenoidal tumor resection seems to lead to improved patient outcomes
Liang Xue
Liang Xue
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
Department of Neurosurgery, 900TH Hospital of the Joint Logistics Support Force, Fuzhou, Fujian, China
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Department of Neurosurgery, 900TH Hospital of the Joint Logistics Support Force, Fuzhou, Fujian, China
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Jianwu Wu
Jianwu Wu
Department of Neurosurgery, 900TH Hospital of the Joint Logistics Support Force, Fuzhou, Fujian, China
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Jie Chen
Jie Chen
Department of Radiology, 900TH Hospital of the Joint Logistics Support Force, Fuzhou, Fujian, China
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Yongkai Yang
Yongkai Yang
Department of Neurosurgery, Affiliated Fuzhou First Hospital of Fujian Medical University, Fuzhou, Fujian, China
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consent to use their clinical data for research purposes, and all data were anonymized. We included patients who underwent (i) microscopic TSS for PAs, (ii) surgery for the first time, and (iii) repeated MRI examinations 2–3 days after surgery. We
Kunzhe Lin
Kunzhe Lin
Department of Neurosurgery, Affiliated Fuzhou First Hospital of Fujian Medical University, Fuzhou, China
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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Lingling Lu
Lingling Lu
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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Zhijie Pei
Zhijie Pei
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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Shuwen Mu
Shuwen Mu
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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Shaokuan Huang
Shaokuan Huang
Department of Neurosurgery, Guiqian International General Hospital, Guiyang, China
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Shousen Wang
Shousen Wang
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
Department of Neurosurgery, 900th Hospital, Fuzhou, China
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Department of Neurosurgery, 900th Hospital, Fuzhou, China
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reduce the degree of injury and the incidence of postoperative-delayed hyponatremia. The present study evaluated delayed hyponatremia incidence and duration after pituitary adenoma resection via microscopic TSS and identified the predictive factors
Prachi Bansal
Prachi Bansal
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Anurag Lila
Anurag Lila
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Manjunath Goroshi
Manjunath Goroshi
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Swati Jadhav
Swati Jadhav
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Nilesh Lomte
Nilesh Lomte
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Kunal Thakkar
Kunal Thakkar
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Atul Goel
Atul Goel
Department of Neurosurgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Abhidha Shah
Abhidha Shah
Department of Neurosurgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Shilpa Sankhe
Shilpa Sankhe
Department of Radiology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Naina Goel
Naina Goel
Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Neelam Jaguste
Neelam Jaguste
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Tushar Bandgar
Tushar Bandgar
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Nalini Shah
Nalini Shah
Department of Endocrinology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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tests have been reported to be positive predictors of sustained remission ( 8 , 9 , 10 ). In the current study, we report long-term follow-up of CD patients after first microscopic TSS. We aim to study the post-operative remission and long
Amir H Zamanipoor Najafabadi
Amir H Zamanipoor Najafabadi
Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Centre and Haga Teaching Hospitals, Leiden and The Hague, The Netherlands
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Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Centre and Haga Teaching Hospitals, Leiden and The Hague, The Netherlands
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Merel van der Meulen
Merel van der Meulen
Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
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Ana Luisa Priego Zurita
Ana Luisa Priego Zurita
Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
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S Faisal Ahmed
S Faisal Ahmed
Chair of Work Package of E-Health & ICT of Endo-ERN, Developmental Endocrinology Research Group, School of Medicine, Dentistry & Nursing, University of Glasgow and Office for Rare Conditions, Royal Hospital for Children & Queen Elizabeth University Hospital, Glasgow, UK
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Wouter R van Furth
Wouter R van Furth
Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
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Evangelia Charmandari
Evangelia Charmandari
Pediatric Chair Main Thematic Group 6 Pituitary of Endo-ERN, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
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Olaf Hiort
Olaf Hiort
Pediatric Chair and Deputy Coordinator of Endo-ERN, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany
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Alberto M Pereira
Alberto M Pereira
Adult Chair and Coordinator of Endo-ERN, Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Mehul Dattani
Mehul Dattani
London Centre for Pediatric Endocrinology and Diabetes at Great Ormond Street Children's Hospital and University College London Hospitals, London, UK
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Diana Vitali
Diana Vitali
SOD ITALIA (Italian Organization for Septo Optic Dysplasia and other Neuroendocrine Disorders), European Patient Advocacy Group, Rome, Italy
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Johan P de Graaf
Johan P de Graaf
Dutch Pituitary Foundation, European Patient Advocacy Group, Nijkerk, The Netherlands
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Nienke R Biermasz
Nienke R Biermasz
Adult Chair Main Thematic Group 6 Pituitary of Endo-ERN, Department of Medicine, Division of Endocrinology and Centre for Endocrine Tumors, Leiden University Medical Centre, Leiden, The Netherlands
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network role in their region. The following data points were extracted from each article, if possible, separately for different adenoma types: authors, year of publication, number of described patients, used surgical technique (endoscopic vs microscopic
Anna Malczewska
Anna Malczewska
Department of Endocrinology and Neuroendocrine Tumours, Medical University of Silesia, Katowice, Poland
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Kjell Oberg
Kjell Oberg
Department of Endocrine Oncology, University Hospital, Uppsala, Sweden
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Beata Kos-Kudla
Beata Kos-Kudla
Department of Endocrinology and Neuroendocrine Tumours, Medical University of Silesia, Katowice, Poland
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NETest measurement evaluated at the same time-point. Assay sensitivity was assessed to detect image-positive or microscopic disease and specificity in the disease-free cohort. Histological and radiological parameters were established by the independent
Liza Das
Liza Das
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, (PGIMER), Chandigarh, India
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Kim Vaiphei
Kim Vaiphei
Department of Histopathology, PGIMER, Chandigarh, India
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Ashutosh Rai
Ashutosh Rai
Department of Translational and Regenerative Medicine, PGIMER, Chandigarh, India
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Chirag Kamal Ahuja
Chirag Kamal Ahuja
Department of Radiology, PGIMER, Chandigarh, India
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Paramjeet Singh
Paramjeet Singh
Department of Radiology, PGIMER, Chandigarh, India
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Ishani Mohapatra
Ishani Mohapatra
Department of Pathology and Laboratory Medicine, Medanta, The Medicity, Gurgaon, India
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Rajesh Chhabra
Rajesh Chhabra
Department of Neurosurgery, PGIMER, Chandigarh, India
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Anil Bhansali
Anil Bhansali
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, (PGIMER), Chandigarh, India
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Bishan Dass Radotra
Bishan Dass Radotra
Department of Histopathology, PGIMER, Chandigarh, India
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Ashley B Grossman
Ashley B Grossman
Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Green Templeton College, University of Oxford, Oxford, UK
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Green Templeton College, University of Oxford, Oxford, UK
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Márta Korbonits
Márta Korbonits
Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Pinaki Dutta
Pinaki Dutta
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, (PGIMER), Chandigarh, India
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, hyposomatotropism, DI Year of surgery 2014 2013 2013 Type of procedure Microscopic TSS Microscopic TSS Neuronavigation guided free bone flap fronto-temporal craniotomy Intra-operative impression Vascular Highly vascular Highly
Ayana Suzuki
Ayana Suzuki
Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan
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Mitsuyoshi Hirokawa
Mitsuyoshi Hirokawa
Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan
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Izumi Otsuka
Izumi Otsuka
Secretary Section, Kuma Hospital, Kobe, Japan
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Akihiro Miya
Akihiro Miya
Department of Surgery, Kuma Hospital, Kobe, Japan
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Akira Miyauchi
Akira Miyauchi
Department of Surgery, Kuma Hospital, Kobe, Japan
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Takashi Akamizu
Takashi Akamizu
Department of Internal Medicine, Kuma Hospital, Kobe, Japan
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malignant. The re-aspiration rate was higher than that in WTD-MCs (25.0%) and SAD-MCs (58.3%), with no significant difference. Table 2 shows the surgical, microscopic, and postoperative findings. Total thyroidectomy and lateral neck lymph node dissection
Natalio García-Honduvilla
Natalio García-Honduvilla
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
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Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
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Alberto Cifuentes
Alberto Cifuentes
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Miguel A Ortega
Miguel A Ortega
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Marta Pastor
Marta Pastor
Biopraxis Research AIE, Álava, Spain
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Garazi Gainza
Garazi Gainza
Biopraxis Research AIE, Álava, Spain
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Eusebio Gainza
Eusebio Gainza
Biopraxis Research AIE, Álava, Spain
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Julia Buján
Julia Buján
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
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Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
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Melchor Álvarez-Mon
Melchor Álvarez-Mon
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
Immune System Diseases-Rheumatology and Oncology Service, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
Immune System Diseases-Rheumatology and Oncology Service, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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local treatment with rhEGF. Protocol 1 ( n = 53) was used for the macroscopic and microscopic analyses of the reparative process and the evaluation of different doses. After this, Protocol 2 ( n = 48) was performed to study the immune response during
