Endoscopic transsphenoidal pituitary surgery: a single surgeon experience and the learning curve.

Abstract:

:Endoscopic transsphenoidal surgery for pituitary adenomas has been introduced as an alternative to transsphenoidal microsurgery. This is the first Australian study to evaluate a single surgeon's experience by comparing our results with other series and attempting to identify a learning curve. Retrospective analysis was carried out on 79 consecutively treated patients by fully endoscopic transsphenoidal surgery by a single neurosurgeon over a period spanning from July 1998 to September 2010 at St George Public and Private hospitals. The mean age at time of surgery was 56.7 years (SD ± 16.3, range 26-85) and the mean follow-up period was 38.2 months (SD ± 33, range 1-136). Gross total resection (GTR) was noted in 63% of patients, endocrinological cure was achieved in 53% and visual field improvements were noted in 86% of patients. Intra-operative CSF leaks occurred in 19% of procedures, while the rates of post-operative CSF rhinorrhea was 3% and post-operative diabetes insipidus was 13%. There was one post-operative death (1%). Compared to microsurgery, intra-operative CSF leaks and meningitis seem less frequent with an endoscopic approach. With increasing experience, we found a non-statistically significant trend towards higher rates of GTR, and improved visual fields. Endocrinological cure rates were clearly better with experience (p < 0.01). There may be a learning curve that can be overcome in 30-40 cases. Endoscopic transsphenoidal surgery provides similar tumour and patient outcomes when compared to transsphenoidal microsurgery. In this single surgeon's experience, there was a trend to indicate improved performance with more case experience.

journal_name

Br J Neurosurg

authors

Bokhari AR,Davies MA,Diamond T

doi

10.3109/02688697.2012.709554

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

44-9

issue

1

eissn

0268-8697

issn

1360-046X

journal_volume

27

pub_type

杂志文章
  • Treatment of CSF leakage and infections of dural substitute in decompressive craniectomy using fascia lata implants and related anatomopathological findings.

    abstract::Purpose: Decompressive craniectomy (DC) is widely used to treat raised intracranial pressure (ICP) in cranial trauma and stroke. It is accompanied by numerous complications. The aim of our study is to assess the surgical treatment of infections related to the use of a dural substitute with concurrent CSF leakage perfo...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1735301

    authors: Callovini GM,Bolognini A,Callovini T,Giordano M,Gazzeri R

    更新日期:2020-03-06 00:00:00

  • Intraparenchymal and intrasylvian haematomas secondary to ruptured middle cerebral artery aneurysms: prognostic factors and therapeutic considerations.

    abstract::The aim of this study was to investigate prognostic factors and the most appropriate treatment for patients with ruptured middle cerebral artery (MCA) aneurysms in relation to haematoma distribution. Ninety-two patients with ruptured MCA aneurysms, who underwent surgery during the last 11 years from 1986 to 1996, were...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699944131

    authors: Yoshimoto Y,Wakai S,Satoh A,Hirose Y

    更新日期:1999-02-01 00:00:00

  • IDH mutation analysis in gliomas as a diagnostic and prognostic biomarker.

    abstract:INTRODUCTION:There is a high rate of IDH1/2 mutations in low grade gliomas and in high grade gliomas deriving from them. IDH analysis of gliomas is a novel method of classification and an independent prognostic marker. We compared antibody and sequencing methods for the detection of IDH mutations. METHOD:88 samples fr...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.771139

    authors: Kurian KM,Haynes HR,Crosby C,Hopkins K,Williams M

    更新日期:2013-08-01 00:00:00

  • Chlorpromazine in combination with nitrosourea inhibits experimental glioma growth.

    abstract::Modern cancer therapy has improved the prognosis for several tumour types. This, however, does not apply to the largest group of brain tumours, the malignant astrocytomas grades III-IV. Hence, there is need for new ideas to improve treatment. Ca2+ and the Ca(2+)-binding protein calmodulin have been shown to be involve...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699409027965

    authors: Aas AT,Brun A,Pero RW,Salford LG

    更新日期:1994-01-01 00:00:00

  • Retrospective observational comparative study of Hemilaminectomy versus Laminectomy for intraspinal tumour resection; Shorter Stays, Lower Analgesic Usage and Less Kyphotic Deformity.

    abstract:INTRODUCTION:Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less po...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2014.1003026

    authors: Millward CP,Bhagawati D,Chan HW,Bestwick J,Brecknell JE

    更新日期:2015-06-01 00:00:00

  • Failure to follow patients with hydrocephalus shunts can lead to death.

    abstract::Failure to follow patients with hydrocephalus can expose them to potentially fatal consequences. Two cases are used to illustrate this and the merits of follow-up of these patients are discussed. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699844574

    authors: Buxton N,Punt J

    更新日期:1998-10-01 00:00:00

  • Delayed diagnosis, due to the associated radiological abnormalities, of spontaneous intracranial hypotension caused by cerebrospinal fluid leakage at C1-2.

    abstract::Spontaneous intracranial hypotension (SIH) is an uncommon clinical entity that is often diagnosed after a delay, or it is misdiagnosed due to the variety of clinical presentations and the associated radiological findings. We present here a case of SIH associated with chronic subdural haematoma (SDH) and subarachnoid h...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690701790597

    authors: Joo WI,Lee KJ,Rha HK,Park HK,Chough JK

    更新日期:2008-04-01 00:00:00

  • ETV for successful treatment of holocord syrinx with hydrocephalus: a case report.

    abstract::Aim: to present evidence for the use of endoscopic third ventriculostomy (ETV) in the treatment of holocord syrinx.Methods: ETV has been used in the treatment of obstructive hydrocephalus and syringomyelia secondary to Chiari 1 malformation. However, there have been no reports of ETV being utilised in the management o...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1718603

    authors: Rose L,Aldridge W,Henderson D,Cox M,Sinha S

    更新日期:2020-01-29 00:00:00

  • Solitary fibrous tumour of the IV ventricle.

    abstract:BACKGROUND:Solitary Fibrous Tumour (SFT) is a rare tumour occurring mainly in the pleural cavity, with less than 100 cases reported in the Central Nervous System, where it typically presents as a meningeal-based lesion. We describe the case of a SFT located in the fourth ventricle and briefly review the pertinent liter...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688691003675226

    authors: Montano N,Doglietto F,Lauriola L,Signorelli F,Pallini R

    更新日期:2010-08-01 00:00:00

  • Endovascular stenting of the transverse sinus in a patient presenting with benign intracranial hypertension.

    abstract::The authors present a 37-year-old lady with symptoms and signs suggestive of benign intracranial hypertension (BIH). Routine CT and MRI scans were normal. Further investigations were performed with magnetic resonance venography (MRV) and cerebral venography. These revealed obstruction of the right transverse sinus wit...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690310001627821

    authors: Ogungbo B,Roy D,Gholkar A,Mendelow AD

    更新日期:2003-12-01 00:00:00

  • Cryptococcal granuloma of the the basal ganglia with fatal haemorrhage after stereotactic biopsy: case report.

    abstract::This paper presents a male, immunocompetent case aged 62-year-old with cryptococcal granuloma in the basal ganglia. No cryptococcal infection occurred in other areas. The diagnosis was made by biopsy. Cryptococcal granuloma was tough and unsuitable for sterotactic biopsy. The patient died of postoperative bleeding and...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1550190

    authors: Wang G,Shen H,Chu Z,Shen J,Wang Y

    更新日期:2019-01-17 00:00:00

  • Lymphocytic and granulocytic hypophysitis: a single centre experience.

    abstract::Lymphocytic and granulocytic hypophysitis are rare pituitary masses. A series of five dealt with at a single centre is presented and discussed. Retrospective analysis of pathology records revealed the cases. Of pituitary mass lesions dealt with in this centre, 0.8% have the diagnosis. Five females presented, one pregn...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690120057664

    authors: Buxton N,Robertson I

    更新日期:2001-06-01 00:00:00

  • Carotico-cavernous fistula secondary to Varicella zoster?

    abstract::We describe the case of a previously well, 73-year-old male patient who presented with a spontaneous high flow, carotico-cavernous fistula, 1 month following an attack of herpes zoster. We postulate that the zoster virus was the underlying cause, given the history and time frame between the preceding shingles and the ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688691003634512

    authors: Amato-Watkins A,St George EJ,Saxena A,Bhattacharya J

    更新日期:2010-06-01 00:00:00

  • Head injury rehabilitation: the role of a neurotrauma clinic.

    abstract::Survivors of head injury are often left with varying degrees of disability and complex and varied needs, necessitating prolonged periods of rehabilitation and continuing care. Advances have been made in the acute management of these patients, but continuing management in terms of rehabilitation remains deficient with ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690903078874

    authors: Seeley HM,Kirker S,Harkin C,Dias C,Richards H,Pickard JD,Hutchinson PJ

    更新日期:2009-01-01 00:00:00

  • Anterior cervical discectomy: to graft or not to graft?

    abstract::The debate regarding whether to perform an interbody fusion after anterior cervical discectomy (ACD) has been going on for the last 50 years. Several prospective randomized clinical trials have been performed to evaluate the clinical outcome following anterior cervical discectomy with and without interbody fusion. Non...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690802610249

    authors: Konduru S,Findlay G

    更新日期:2009-02-01 00:00:00

  • Unusual life saving application of intra-operative ultrasound: case report.

    abstract::We report the case of a young woman who developed brain swelling during an ultrasound-guided craniotomy for tumour. A contralateral acute extradural haematoma was identified with the ultrasound and removed. No cause for the extradural was found. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2010.550964

    authors: Tsermoulas G,Mitchell P

    更新日期:2011-06-01 00:00:00

  • Anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma.

    abstract::Coexistence of cerebral aneurysm and untreated craniopharyngioma is extremely rare. We present an extremely rare case of anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma, and discuss the relationship between these two lesions. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2012.701677

    authors: Takeuchi S,Wada K,Sakakibara F,Nawashiro H,Mori K

    更新日期:2013-02-01 00:00:00

  • Surgical resection of developmental venous anomaly causing massive intracerebral haemorrhage: a case report.

    abstract::Abstract Cerebral developmental venous anomalies (DVAs) very rarely cause massive haematoma, but should be included in the differential diagnosis of atypical massive intracerebral haematoma (ICH). We describe a case of massive ICH caused only by a DVA and successfully treated by haematoma evacuation with surgical rese...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.815318

    authors: Nagatani K,Osada H,Takeuchi S,Otani N,Wada K,Mori K

    更新日期:2014-01-01 00:00:00

  • Publication fate of abstracts presented at Society of British Neurological Surgeons meetings.

    abstract:INTRODUCTION:Society of British Neurological Surgeons (SBNS) meetings are important national events which allow for the presentation of current academic work. The publication rate of presented abstracts is considered a proxy marker of the scientific strength of a conference. We aimed to determine the publication fate o...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2014.915008

    authors: Jamjoom AA,Hughes MA,Chuen CK,Hammersley RL,Fouyas IP

    更新日期:2015-04-01 00:00:00

  • Factors responsible for early postoperative mental alterations after bilateral implantation of subthalamic electrodes.

    abstract:INTRODUCTION:Early postoperative mental changes are the most frequent problem after bilateral subthalamic electrode implantation. The study aims to find an association between them and factors related to patient, disease and surgery, including the size of the third ventricle as brain atrophy marker. MATERIAL AND METHO...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2016.1226256

    authors: Hrabovsky D,Balaz M,Rab M,Feitova V,Hummelova Z,Novak Z,Chrastina J

    更新日期:2017-04-01 00:00:00

  • Trephine approach to anterior midline aneurysms--an initial communication.

    abstract::The outcome of two groups of patients wtih midline aneurysms exposed by two different approaches was compared. The initial results support a clinical impression that a trephine approach has the following advantages: (1) adequate exposure with the best possible anatomical orientation and (2) a reduced morbidity. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699008992743

    authors: Keogh AJ

    更新日期:1990-01-01 00:00:00

  • Multilayer reconstruction of the anterior cranial fossa floor.

    abstract::A case is described where a reconstruction of a complex defect in the floor of anterior cranial fossa was successfully carried out using multiple layers of vascularised pedicle flaps. The 42-year-old male patient had previously undergone multiple surgical procedures for persistent cerebrospinal fluid (CSF) rhinorrhoea...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699845096

    authors: Goel A

    更新日期:1998-06-01 00:00:00

  • The use of the nasoseptal flap to reduce the rate of post-operative cerebrospinal fluid leaks following endoscopic trans-sphenoidal surgery for pituitary disease.

    abstract:INTRODUCTION:Our aim was to evaluate the routine use of a pedicled nasoseptal flap (NSF) as a primary repair for intra-operative CSF leaks compared with fat/fascia lata graft and lumbar drain insertion by performing a retrospective review of elective patients undergoing primary trans-sphenoidal surgery from January 200...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.795525

    authors: Horridge M,Jesurasa A,Olubajo F,Mirza S,Sinha S

    更新日期:2013-12-01 00:00:00

  • Endoscopic endonasal resection of a medullary cavernoma: a novel case.

    abstract::Brainstem cavernomas can present very challenging operative problems. Endoscopic endonasal approaches to these lesions in the mesencephalon and pons have been described. In this article the authors present the first case of a medullary cavernoma resected by an endoscopic transclival approach. A 26 year-old woman with ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2017.1408777

    authors: Alikhani P,Sivakanthan S,Ashour R,Tabor M,van Loveren H,Agazzi S

    更新日期:2019-12-01 00:00:00

  • Minimalist placement of external ventricular drains. A quick, safe, cheap and cosmetic procedure.

    abstract::We report the use of a twist drill method for placement of external ventricular drains and ventriculoperitoneal shunts. We have found this method to be efficient and safe, and provides an excellent cosmetic effect. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/026886900417333

    authors: Timothy J,Hall G,Chumas P

    更新日期:2000-08-01 00:00:00

  • Transsphenoidal pituitary surgery in the elderly is safe and effective.

    abstract:OBJECT:With an increasingly ageing population, the number of elderly people diagnosed with pituitary tumours continues to rise. There is a concern that with increasing age and comorbidities, there is higher anaesthetic risk, as well as peri-operative morbidity and mortality from pituitary surgery. This study aimed to a...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.872225

    authors: Pereira EA,Plaha P,Chari A,Paranathala M,Haslam N,Rogers A,Korevaar T,Tran D,Olarinde R,Karavitaki N,Grossman AB,Cudlip SA

    更新日期:2014-10-01 00:00:00

  • Spinal arteriovenous malformations and subarachnoid haemorrhage.

    abstract::Seventy patients with spinal arteriovenous malformations (AVMs) referred to the author over a 25-year period (1958-82), were equally divided between congenital, intradural and acquired, dural lesions. Amongst the intradural AVMs, were 22 with subarachnoid haemorrhage (SAH), a presenting feature in 18. The clinical fin...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699209002895

    authors: Shephard RH

    更新日期:1992-01-01 00:00:00

  • Isolated massive intraventricular haemorrhage without subarachnoid haemorrhage due to rupture of a posterior communicating artery aneurysm.

    abstract::The classical presentation of a ruptured intracranial aneurysm is subarachnoid haemorrhage (SAH). We present a rare case of a ruptured posterior communicating artery (PcomA) aneurysm presented solely with massive intraventricular haemorrhage (IVH) in a 53-year-old female. The aneurysm was coiled successfully and the o...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2017.1406451

    authors: Anagnostopoulos C,Chamilos C,Hadjigeorgiou GF,Petsanas A

    更新日期:2019-10-01 00:00:00

  • Visual outcome after transsphenoidal surgery for pituitary adenomas.

    abstract::We have reviewed the records of 53 patients with visual impairment secondary to pituitary macroadenomas and studied the visual outcome after surgery. After transsphenoidal procedures visual field defects improved in 89% of the patients and visual acuity improved in 82%. There were 13 cases of acute symptomatic intratu...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699550041485

    authors: Peter M,De Tribolet N

    更新日期:1995-04-01 00:00:00

  • Correction factors for gravimetric measurement of peritumoural oedema in man.

    abstract::The water content of samples of normal and oedematous brain in lobectomy specimens from 16 patients with cerebral tumours has been measured by gravimetry and by wet and dry weighing. Uncorrected gravimetry underestimated the water content of oedematous peritumoural cortex by a mean of 1.17%, and of oedematous peritumo...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698708999634

    authors: Bell BA,Smith MA,Tocher JL,Miller JD

    更新日期:1987-01-01 00:00:00