Abstract：
OBJECTIVE:There are few agreed quantifiable outcome measures in pituitary surgery. The goal of this study is to present the measurement of resection volume after surgery for pituitary tumours as a surgeon-specific outcome measure that may have use in illustrating the performance of individual surgeons internally and externally, and contribute to quality improvement in pituitary surgery. METHOD:The authors used an existing validated method to measure the volume of pituitary tumours. This method was used to retrospectively assess the extent of resection (EOR) in all patients undergoing pituitary surgery for tumour volume reduction over a 3-year period in Leeds, UK. Three surgeons and two techniques (endonasal transsphenoidal surgery and conventional microscopic surgery) were compared. The results are summarised using Funnel plot methodology. RESULTS:The overall mean EOR for the 3 years of study was 54%. There was no difference between endoscopic and microscopic techniques in terms of EOR. Significant differences were found between surgeons' case mix (as estimated by preoperative tumour size) and EOR. One surgeon had smaller tumour cases at operation than the other two surgeons (p = 0.004). One surgeon achieved larger resections than the two other surgeons (p = 0.038 and 0.005). CONCLUSIONS:Measuring pituitary volumes manually using segmentation methods and existing software is possible for surgeons and provides valuable information on individual surgeon performance and departmental practice. A simple retrospective review of 3 years of practice has demonstrated that surgeons have different case-mix and their EOR can vary within safe limits. During a period of transition when we changed personnel and technique, the EOR was little affected and this was reassuring from a governance perspective. Performance assessment for low-volume conditions is possible .
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Phillips N,Tyagi A,Marks P,Nix Pdoi
10.3109/02688697.2013.847172subject
Has Abstractpub_date
2014-06-01 00:00:00pages
368-73issue
3eissn
0268-8697issn
1360-046Xjournal_volume
28pub_type
杂志文章abstract：:Epidermoid tumours are rare intracranial tumours. They are commonly found in the cerebellopontine angle and the suprasellar region. However, they are also known to occur in other locations. Anterior interhemispheric fissure epidermoid cysts are rarer still, and calcification among epidermoids is considered unusual and...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690802109812
更新日期：2009-02-01 00:00:00
abstract：:The implementation of the two-week wait initiative for cancer referrals in the NHS has had a major impact on outpatient services. A low clinical detection rate among GPs for neurological cancer has resulted in a large number of urgent referrals with a low yield of positive diagnoses. We have devised a strategy for min...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690500305365
更新日期：2005-08-01 00:00:00
abstract：:Background: To analysis the role of gamma knife radiosurgery (GKRS) in treatment of the recurrent or residual World Health Organization (WHO) grade II and III meningiomas.Methods: Between 1995 and 2015, a total of 1163 meningioma patients were treated with GKRS at our single institute; 26 atypical and 6 anaplastic men...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2020.1726285
更新日期：2020-06-01 00:00:00
abstract：:CT images of an 18-year-old woman who had sustained head trauma after a motor vehicle accident are presented demonstrating the iatrogenic intracranial placement of a nasopharyngeal airway. Treatment required a decompressive craniectomy, removal of the nasopharyngeal airway under direct vision, and duraplasty. The pati...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2015.1133804
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:To explore the clinical significance of dynamic monitoring of cerebrospinal fluid (CSF) and serum Lactic acid（Lac), neuron-specific enolase (NSE), and the blood-brain barrier (BBB) index in evaluating the condition and prognosis after a severe traumatic brain injury (TBI). METHODS:A total of 52 severe TBI pa...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2020.1823938
更新日期：2020-10-05 00:00:00
abstract：:The cerebellar cognitive affective syndrome (CCAS) was first described by Schmahmann and Sherman as a constellation of symptoms including dysexecutive syndrome, spatial cognitive deficit, linguistic deficits and behavioural abnormalities in patients with a lesion in the cerebellum with otherwise normal brain. Neurosur...
journal_title：British journal of neurosurgery
pub_type： 杂志文章,评审
doi：10.3109/02688697.2014.920487
更新日期：2014-12-01 00:00:00
abstract：:Rupture of cerebral aneurysm during CT angiogram is a rare occurrence. Here we present such a case where an aneurysmal re-rupture during CT angiogram was demonstrated. ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2011.584984
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Wide-necked and non-saccular aneurysms are difficult to treat with coil embolization. The use of stents has expanded the role of endovascular treatment. METHODS:A retrospective study of 43 patients with wide-necked, fusiform or blister aneurysms treated with stent-assisted coiling or stent alone. The review...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2012.757292
更新日期：2013-10-01 00:00:00
abstract：:Angiographic middle and anterior cerebral artery diameter and transcranial ultrasound flow velocity measurements were performed within 24 h of each other in 102 patients with recent aneurysmal subarachnoid haemorrhage. There was a significant inverse correlation between middle cerebral artery diameter and flow velocit...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688699309023812
更新日期：1993-01-01 00:00:00
abstract：:A series of 510 patients with proven aneurysmal subarachnoid haemorrhage (SAH) is reported. The incidence of recurrent haemorrhage during the period awaiting surgery was 13.7%. There was no significant difference in incidence between good and poor grade patients. Following rebleeding there was an immediate mortality o...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688698808999657
更新日期：1988-01-01 00:00:00
abstract：:Cerebellar haemangioblastomas commonly arise in patients with von Hippel - Lindau disease. We present the case of a 47-year-old male who has successfully undergone 10 separate procedures for symptomatic cerebellar haemangioblastomas. To our knowledge, this case is unique with respect to the frequency of symptomatic re...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690701552864
更新日期：2008-02-01 00:00:00
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
更新日期：2009-02-01 00:00:00
abstract：:We present this unusual case of a 60-year-old gentleman who presented with meningism and reduced conscious level. Imaging demonstrated a perforated sigmoid colon with retroperitoneal air associated with pneumorrhachis and pneumocranium. He required a Hartmann's procedure and broad spectrum intra-thecal antibiotics whi...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2010.500420
更新日期：2011-02-01 00:00:00
abstract：:We describe a patient who within 2 months of undergoing radio-chemotherapy for glioblastoma developed an Epstein-Barr virus-positive primary diffuse large B-cell CNS lymphoma. To our knowledge, this is the first such case reported in the literature showing that new tumefactions following aggressive treatment for gliob...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2013.829554
更新日期：2014-04-01 00:00:00
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
更新日期：2010-08-01 00:00:00
abstract：:Stereotactic radiosurgery (SRS) for brain metastases has been carried out at the Leeds Gamma Knife Centre since March 2009. The aim of this study was to examine the outcomes and toxicity in our initial cohort of patients. The medical records of patients with brain metastases referred to the Leeds Gamma Knife Centre be...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2012.690913
更新日期：2012-10-01 00:00:00
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
更新日期：2020-03-06 00:00:00
abstract：:The objective was to measure metabolic changes monitored by bedside microdialysis during impending and manifest hypoxia in traumatic brain injury. In 41 patients, a PtiO2-catheter (Licox; 1/min) was placed into non-lesioned frontal white matter together with a microdialysis catheter (CMA, hourly). Data were analysed f...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690310001601234
更新日期：2003-08-01 00:00:00
abstract：:Subarachnoid hemorrhage with ruptured cerebral artery dissection caused by varicella zoster (VZ) vasculopathy is rare. We report a rare case of vertebral artery (VA) dissection induced by VZ virus, successfully treated with stent-assisted coil embolization and systemic anti viral medication, on six month follow-up cer...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2016.1187256
更新日期：2016-12-01 00:00:00
abstract：:We report a case of pituitary macroadenoma that developed symptomatic vasospasm 12 days after transsphenoidal removal, but showed an excellent recovery following active treatment identical to those for vasopasm following aneurysmal subarachonid haemorrhage. Subarachnoid haematoma in the basal cisterns secondary from p...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690020024391
更新日期：2001-02-01 00:00:00
abstract：:Objective: Mixed growth hormone (GH) and prolactin (PRL) secreting adenomas are the most common type of plurihormonal pituitary adenomas. We assessed the clinical presentations and impacts of transsphenoidal surgery (TS) on patients with mixed GH and PRL adenomas including surgical outcomes, complications, and prognos...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2020.1713989
更新日期：2020-04-01 00:00:00
abstract：:Venous air embolism (VAE) is a potentially serious complication in neurosurgery. It occurs most commonly during craniotomy in the sitting position. Diagnosis is difficult in awake patients on spontaneous ventilation due to different clinical manifestations. Prompt diagnosis and treatment are essential. We report venou...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690902775538
更新日期：2009-08-01 00:00:00
abstract：:We describe the case of a fenestrated basilar artery aneurysm successfully clipped by means of a right presigmoid petrosal approach. Three-dimensional CT angiography enabled the surgeon to plan an approach to an aneurysm in this unique location, and the presigmoid petrosal approach was suitable for clipping of the ane...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688699845311
更新日期：1998-04-01 00:00:00
abstract：:We describe the operative technique and our preliminary experience with use of the Renishaw neuromate(®) stereotactic robot to implant depth electrodes for investigation of focal epilepsy in the UK. Conventional electrocorticography involving a craniotomy and implantation of grids of electrodes directly onto the brain...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688697.2013.798859
更新日期：2013-10-01 00:00:00
abstract：:Simultaneous cerebral blood flow (CBF) and glucose metabolism (CMRglu) studies with a double isotope autoradiographic technique were applied to squirrel monkeys submitted to a unilateral pre- or postganglionic trigeminal lesion. The CBF values were not affected following a pre- or postganglionic lesion per se. In cont...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.3109/02688699209002929
更新日期：1992-01-01 00:00:00
abstract：:During microvascular decompression procedure for trigeminal neuralgia, surgical attention is mainly focused at the neurovascular conflict at trigeminal root entry zone. However, many major complications of this surgery are often related to venous structures in the posterior fossa, including the venous sinuses and the ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690701397773
更新日期：2007-06-01 00:00:00
abstract：BACKGROUND:The graft site morbidity following iliac crest harvesting is significant. To overcome this, different bone substitutes like coral dowels, solvent dissolved bovine/human bone substitutes, and carbon fiber/titanium cages have been used. This study was undertaken to assess the postoperative radiological fusion ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688697.2017.1297362
更新日期：2017-06-01 00:00:00
abstract：:We report a case of extensive osteomyelitis of the skull vault from a human bite. The presentation and surgical management of this unusual condition is described. The microbiological findings are comparable to known patterns of infection after human bites. Surgical management and prophylaxis after this injury are disc...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688699746582
更新日期：1997-04-01 00:00:00
abstract：:Despite advances in understanding, monitoring, and treatment, the outcome of patients with refractory brain oedema (RBE) remains poor. The concept of wide bone removal for treatment of RBE has been recognized since the nineteenth century. Bifrontal decompressive craniectomy (BDC) is performed as last resort treatment ...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690802571094
更新日期：2009-02-01 00:00:00
abstract：:The aim of this report is to introduce a simple modification to the free-hand frameless stereotactic placement of ventriculoperitoneal shunts in undersized ventricles. In this technical note, we describe our experience with ventricular catheter placement in two children suffering from shunt dependent idiopathic intrac...
journal_title：British journal of neurosurgery
pub_type： 杂志文章
doi：10.1080/02688690500495166
更新日期：2005-12-01 00:00:00
