Hypopituitarism surgery: Difference between revisions
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==Overview== | ==Overview== | ||
* | *The feasibility of surgery depends on the clinical condition and underlying etiology. Following conditions need a surgical consideration: | ||
Pituitary apoplexy | |||
* | Microadenomas with GH or ACTH hypersecretion | ||
Debulking macroadenomas with mass symptoms and resistant to medical therapy | |||
*A study showed that non-functioning pituitary adenomas may be prevented from recurrence by gross-total resection and/or adjuvant radiotherapy.<ref name="pmid27195254">{{cite journal |vauthors=Lee MH, Lee JH, Seol HJ, Lee JI, Kim JH, Kong DS, Nam DH |title=Clinical Concerns about Recurrence of Non-Functioning Pituitary Adenoma |journal=Brain Tumor Res Treat |volume=4 |issue=1 |pages=1–7 |year=2016 |pmid=27195254 |pmc=4868810 |doi=10.14791/btrt.2016.4.1.1 |url=}}</ref> | |||
*Literature review has shown better outcomes with endoscopic transsphenoidal surgery when compared to microscopic technique in gross tumor removal as it lowers the risk of CSF leak, septal perforation, infection, hematoma, hypopituitarism, recurrence, and overall mortality. <ref name="pmid28185971">{{cite journal |vauthors=Esquenazi Y, Essayed WI, Singh H, Mauer E, Ahmed M, Christos PJ, Schwartz TH |title=Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas |journal=World Neurosurg |volume=101 |issue= |pages=186–195 |year=2017 |pmid=28185971 |doi=10.1016/j.wneu.2017.01.110 |url=}}</ref><ref name="pmid28104521">{{cite journal |vauthors=Li A, Liu W, Cao P, Zheng Y, Bu Z, Zhou T |title=Endoscopic Versus Microscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenoma: A Systematic Review and Meta-Analysis |journal=World Neurosurg |volume=101 |issue= |pages=236–246 |year=2017 |pmid=28104521 |doi=10.1016/j.wneu.2017.01.022 |url=}}</ref><ref name="pmid24820497">{{cite journal |vauthors=Zhu M, Yang J, Wang Y, Cao W, Zhu Y, Qiu L, Tao Y, Xu Y, Xu H |title=[Endoscopic transsphenoidal surgery versus microsurgery for the resection of pituitary adenomas: a systematic review] |language=Chinese |journal=Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi |volume=49 |issue=3 |pages=236–9 |year=2014 |pmid=24820497 |doi= |url=}}</ref> | |||
==Surgery== | ==Surgery== | ||
Revision as of 18:25, 11 September 2017
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Hypopituitarism Microchapters |
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Hypopituitarism surgery On the Web |
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Risk calculators and risk factors for Hypopituitarism surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
- The feasibility of surgery depends on the clinical condition and underlying etiology. Following conditions need a surgical consideration:
Pituitary apoplexy Microadenomas with GH or ACTH hypersecretion Debulking macroadenomas with mass symptoms and resistant to medical therapy
- A study showed that non-functioning pituitary adenomas may be prevented from recurrence by gross-total resection and/or adjuvant radiotherapy.[1]
- Literature review has shown better outcomes with endoscopic transsphenoidal surgery when compared to microscopic technique in gross tumor removal as it lowers the risk of CSF leak, septal perforation, infection, hematoma, hypopituitarism, recurrence, and overall mortality. [2][3][4]
Surgery
- Surgical intervention is not recommended for the management of [disease name].
OR
- Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
- The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
- The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
- Surgery is the mainstay of treatment for [disease or malignancy].
Indications
References
- ↑ Lee MH, Lee JH, Seol HJ, Lee JI, Kim JH, Kong DS, Nam DH (2016). "Clinical Concerns about Recurrence of Non-Functioning Pituitary Adenoma". Brain Tumor Res Treat. 4 (1): 1–7. doi:10.14791/btrt.2016.4.1.1. PMC 4868810. PMID 27195254.
- ↑ Esquenazi Y, Essayed WI, Singh H, Mauer E, Ahmed M, Christos PJ, Schwartz TH (2017). "Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas". World Neurosurg. 101: 186–195. doi:10.1016/j.wneu.2017.01.110. PMID 28185971.
- ↑ Li A, Liu W, Cao P, Zheng Y, Bu Z, Zhou T (2017). "Endoscopic Versus Microscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenoma: A Systematic Review and Meta-Analysis". World Neurosurg. 101: 236–246. doi:10.1016/j.wneu.2017.01.022. PMID 28104521.
- ↑ Zhu M, Yang J, Wang Y, Cao W, Zhu Y, Qiu L, Tao Y, Xu Y, Xu H (2014). "[Endoscopic transsphenoidal surgery versus microsurgery for the resection of pituitary adenomas: a systematic review]". Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi (in Chinese). 49 (3): 236–9. PMID 24820497.