scholarly journals A Systematic Review of the Prophylactic Antibiotic Use in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions

2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Author(s):  
Ioana Moldovan ◽  
Charles Agbi ◽  
Shaun Kilty ◽  
Fahad Alkherayf
Keyword(s):  
Systematic Review ◽  
Transsphenoidal Surgery ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Endoscopic Endonasal ◽  
Endoscopic Endonasal Transsphenoidal Surgery

scholarly journals P.057 A systematic review of the prophylactic antibiotic use in endoscopic endonasal transsphenoidal surgery for pituitary lesions

2018 ◽  
Vol 45 (s2) ◽  
pp. S30-S31
Author(s):  
ID Moldovan ◽  
C Agbi ◽  
S Kilty ◽  
F Alkherayf
Keyword(s):  
Systematic Review ◽  
Transsphenoidal Surgery ◽  
Observational Studies ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Series Data ◽  
Inclusion Criteria ◽  
Endoscopic Endonasal ◽  
Number Of Patients ◽  
Endoscopic Endonasal Transsphenoidal Surgery

Background: The benefit of prophylactic antibiotic use in endoscopic endonasal transsphenoidal surgery (EETS) for pituitary lesions is controversial. Many surgeons administer antibiotics perioperatively not based on clear guidelines but “to be safe”. Methods: A systematic review using PRISMA guidelines was performed to assess the efficacy of perioperative antibiotic use to prevent infectious complications in patients undergoing EETS. Inclusion criteria: randomized controlled trials, systematic reviews, observational studies, and case series. Data extracted: study design, year of publication, sample size, surgery type, perioperative antibacterial treatment (antibiotic, dose, and duration), number of patients with 30-days post-operative meningitis and/or sinusitis. End points: rates of meningitis and sinusitis post-EETS. Results: A total of 280 articles were identified. Four observational studies met inclusion criteria. Based on GRADE score these studies were considered low in quality. 633 patients were -included in those studies. The most common antibiotics used were cefazolin and ceftazidime. The rate of infection ranged from 0.5% to 3.1 % for meningitis as the most common infection. Conclusions: The need to use antibiotic(s) perioperatively is not clear in patients with pituitary lesions undergoing EETS. Randomized control trials are needed to evaluate the efficacy of prophylactic antibiotic use in patients with pituitary lesions undergoing EETS.

scholarly journals Application of 3D printed model for planning the endoscopic endonasal transsphenoidal surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xing Huang ◽  
Ni Fan ◽  
Hai-jun Wang ◽  
Yan Zhou ◽  
Xudong Li ◽  
...  
Keyword(s):  
3D Printing ◽  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Three Dimensional ◽  
Spatial Relationship ◽  
Cranial Computed Tomography ◽  
Imaging Data ◽  
Endoscopic Endonasal ◽  
Endoscopic Endonasal Transsphenoidal Surgery

AbstractThe application of 3D printing in planning endoscopic endonasal transsphenoidal surgery is illustrated based on the analysis of patients with intracranial skull base diseases who received treatment in our department. Cranial computed tomography/magnetic resonance imaging data are attained preoperatively, and three-dimensional reconstruction is performed using MIMICS (Materialise, Leuven, Belgium). Models of intracranial skull base diseases are printed using a 3D printer before surgery. The models clearly demonstrate the morphologies of the intracranial skull base diseases and the spatial relationship with adjacent large vessels and bones. The printing time of each model is 12.52–15.32 h, and the cost ranges from 900 to 1500 RMB. The operative approach was planned in vitro, and patients recovered postoperatively well without severe complications or death. In a questionnaire about the application of 3D printing, experienced neurosurgeons achieved scores of 7.8–8.8 out of 10, while unexperienced neurosurgeons achieved scores of 9.2–9.8. Resection of intracranial skull base lesions is demonstrated to be well assisted by 3D printing technique, which has great potential in disclosing adjacent anatomical relationships and providing the required help to clinical doctors in preoperative planning.

Calvian Endo-pen: New Coagulation Forceps for Endoscopic Endonasal Transsphenoidal Surgery

2018 ◽  
Vol 79 (06) ◽  
pp. 524-527
Author(s):  
Steffen Rosahl ◽  
Geralf Kellner ◽  
Rüdiger Gerlach
Keyword(s):  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Endoscopic Endonasal ◽  
Small Vessels ◽  
The Past ◽  
Bipolar Electrocoagulation ◽  
New Type ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Skull Base Lesions ◽  
Anatomical Area

Objective Over the past few years bipolar electrocoagulation techniques in neurosurgery have been continually improving. However, limited access during endoscopic endonasal transsphenoidal surgery (EETS) for central skull base pathologies and the requirement of very precise coagulation in that dedicated anatomical area requires further refinement of bipolar coagulation instruments. We describe our experience (effectiveness of coagulation, intraoperative handling, and the use as a dissecting tool) with a new type of coagulation forceps, the Calvian endo-pen (Sutter Medizintechnik, Freiburg, Germany) during EETS. Method From June to August 2015, 12 patients with central skull base lesions (9 with a pituitary adenoma and 1 each with epidermoid, hemangioma, and juvenile angiofibroma) were operated on with the Calvian endo-pen. Results The application of the Calvian endo-pen was feasible in all cases. The angled thin tips proved to be very effective and precise for soft tissue coagulation to achieve hemostasis. Even very small vessels could be occluded selectively. It was also helpful for outward dissection in separating normal from tumor tissue. Conclusion The use of the Calvian endo-pen is safe and effective during EETS for central skull base pathologies. Its ease in intraoperative handling (maneuverability, cleaning) and precise coagulation makes it a promising instrument for EETS.

Sign in / Sign up

Export Citation Format

Share Document