scholarly journals Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255599
Author(s):  
Jiun-Lin Yan ◽  
Chen-Nen Chang ◽  
Pin-Yuan Chen
Keyword(s):  
Visual Field ◽  
Surgical Outcomes ◽  
Transsphenoidal Surgery ◽  
Pituitary Tumors ◽  
Safe Procedure ◽  
Pituitary Macroadenoma ◽  
Residual Rate ◽  
Surgery Group ◽  
Surgical Data ◽  
The One

Background The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instruments can be restrictive. The two-hand procedure using a one-and-half nostril approach provides more precise manipulation. This study aimed to compare the surgical outcomes of one-hand/mono-nostril and two-hand/one-and-half nostril surgeries for resection of large pituitary tumors by a single neurosurgeon. Materials and methods The surgical data of 78 consecutive cases with pituitary macroadenoma (diameter >1 cm) were reviewed retrospectively. Altogether, 30 cases received one-hand/mono-nostril surgery, while 48 cases received two-hand/one-and-half nostril surgery. Postoperative outcomes of the two operations were compared. Results The operative time, hospital stay, residual rate of pituitary macroadenoma, visual field, surgical complications, and re-operative rates were slightly improved in the two-hand/one-and-half nostril surgery group compared with that in the one-hand/mono-nostril surgery group (all p>0.05). However, postoperative hypopituitarism was less frequent (1/48; 2.0%) with the two-hand/one-and-half nostril approach than with the mono-nostril approach (p = 0.004). Similar surgical outcomes were found in all patients with either small or large pituitary tumors, except that the difference in postoperative improvement in visual field change reached statistical significance (p = 0.044). Conclusion A single-surgeon endoscopic endonasal transsphenoidal surgery with two-hand/one-and-half nostril approach is an effective and safe procedure for removal of large pituitary tumors.

Use of intraoperative intracavitary (direct-contact) ultrasound for resection control in transsphenoidal surgery for pituitary tumors: evaluation of a microsurgical series

2018 ◽  
Vol 161 (1) ◽  
pp. 109-117 ◽  
Author(s):  
Ali Alomari ◽  
Christian Jaspers ◽  
Wolf-Dieter Reinbold ◽  
Joachim Feldkamp ◽  
Ulrich J. Knappe
Keyword(s):  
Transsphenoidal Surgery ◽  
Direct Contact ◽  
Pituitary Tumors ◽  
Resection Control

Red Desaturation and Visual Field Deficits in Detecting Chiasmopathy in Patients with Nonfunctioning Pituitary Macroadenoma

2011 ◽  
pp. P1-430-P1-430
Author(s):  
Emily Shortridge ◽  
Brian Kim ◽  
William White ◽  
Andrew Little ◽  
Kristina Chapple ◽  
...  
Keyword(s):  
Visual Field ◽  
Pituitary Macroadenoma ◽  
Visual Field Deficits

scholarly journals Hemorrhage in long segment cervical schwannoma; case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 476
Author(s):  
Prashant Raj Singh ◽  
Nitish Nayak ◽  
Surendra Kumar Gupta ◽  
Raghavendra Kumar Sharma ◽  
Anju Shukla ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Clinical Outcomes ◽  
Surgical Outcomes ◽  
Multiple Factors ◽  
Pathological Characteristics ◽  
S 100 ◽  
Subdural Hemorrhages ◽  
The One ◽  
Subarachnoid Hemorrhages

Background: Although hemorrhages associated with cervical and thoracic intraspinal schwannomas are typically localized to the subarachnoid hemorrhages (SAH) or subdural hemorrhages (SDH) compartments, rare intratumoral bleeds may also occur. Methods: In the literature, we found and analyzed multiple factors for 13 cases (e.g., epidemiological, clinical, and pathological) of cervical schwannomas with intratumoral hemorrhages (ITH). We added the 14th case of a 35-year-old female with along segment cervical schwannoma with ITH who presented with acute quadriplegia and respiratory decompensation. Results: These 14 patients averaged 51.77 years of age, 60% were male, and the tumor involved 2.83 segments. The incidence of SAH and ITH was noted in five cases each, while SDH’s were very rare. The pathological characteristics were consistent with the diagnosis of cellular schwannomas with S-100 positivity. The clinical outcomes were good (100%) in all the cases, including the one presented (modified McCormick score III). Conclusion: Cervical schwannomas with ITH are rare, and the surgical outcomes in such patients are good-excellent (>90%). The histopathology is always of prime importance and decisive in establishing and confirming the etiology of such ITH.

scholarly journals Laparoscopic Risk-Reducing Salpingo-Oophorectomy: The Brigham and Women's Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Melina Shoni ◽  
Taymaa May ◽  
Allison F. Vitonis ◽  
Anjelica Garza ◽  
Michael G. Muto ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Admission Rate ◽  
Safe Procedure ◽  
Short Term ◽  
Surgical Morbidity ◽  
Hospital Admission Rate ◽  
Estimated Blood Loss ◽  
Risk Reducing

Objective. To establish short-term surgical outcomes of three-port laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in women with hereditary breast-ovarian cancer syndrome (HBOC). Methods. The medical records of all HBOC women that underwent laparoscopic RRSO between January 2001 and December 2010 were retrospectively reviewed. Demographic data, operative details, and short-term surgical outcomes were obtained and subjected to SAS. Statistical univariate and multivariate analyses were performed. Results. 358 patients met study criteria with 277 (77.4%) carrying a documented BRCA mutation. The predominant technique utilized three ports (two 5 mm and one 10/12 mm), a 5 mm laparoscope and a 5 mm Ligasure pulsatile bipolar device. Mean operative time was 58.3 minutes (SD 22.6, 26.0–197.0), significantly affected by BMI greater than 30 (P<0.0001) and status of adhesions (P=0.001). Estimated blood loss (EBL) was negligible in 96.9% of cases. Seven patients required conversion to laparotomy. No major intraoperative complications were recorded. One-night hospital admission rate was less than 2.0% while postoperative complication rate was 3.1%. Malignancy was revealed in 14 patients (3.9%). Conclusion. In HBOC population, three-port laparoscopic RRSO is a simple, reproducible, and safe procedure with low conversion rate, short operative time, minimal EBL, low surgical morbidity, and rapid postoperative recovery.

scholarly journals Pituitary Macroadenoma Manifesting As Acromegaly: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 07-11
Author(s):  
Dian Primadia Putri ◽  
Brama Ihsan Sazli
Keyword(s):  
Brain Mri ◽  
Pituitary Tumors ◽  
Serum Levels ◽  
High Serum ◽  
Pituitary Macroadenoma ◽  
Case Presentation ◽  
Clinical Disorder ◽  
Comprehensive Management ◽  
Management Plans ◽  
Chief Complaints

Background: Acromegaly is an uncommon clinical disorder driven by high serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Over 99% of patients with acromegaly harbor a GH emitting pituitary adenoma. Pituitary tumors represent about 15% of essential intracranial neoplasms. Case presentation: A 38 years old woman, was referred to the H. Adam Malik central public hospital on December 15th, 2020, with chief complaints of enlarged fingers and toes. The patient complained that the patient's fingers and toes were getting bigger in the past 2 years. The brain MRI was performed showed intrasella spherical intensity lesions measuring ± 2.3x1.5x2 cm with the impression of macroadenoma. The patient later diagnosed with acromegaly due to pituitary macroadenoma. Therefore the patient was treated with administration of sandostatin injection, novorapid 6-6-6 IU SC, then 0-0-12 IU SC, 3x1 salt capsules. The patient is also consulted to the neurosurgery department for surgical management plans and a consulted to the Ophthalmology Department. Conclusion: We report an instance of acromegaly suspected because of pituitary macroadenoma in a patient with unmistakable clinical highlights, with comprehensive management.

scholarly journals Endocrine Disorders in a Specialized Hospital in Guyana

2019 ◽  
pp. 30-31
Author(s):  
Yaquelin Gonzalez Ricardo ◽  
Yaritza Lopez Diaz ◽  
Ravendra Johnaton Dudnauth ◽  
Maritza Oliva Perez
Keyword(s):  
Diabetes Mellitus ◽  
Pituitary Tumors ◽  
Obstetric Care ◽  
Endocrine Disorders ◽  
Patients With Diabetes ◽  
Sheehan Syndrome ◽  
One Year ◽  
The One ◽  
Low Prevalence ◽  
Endocrinology Clinic

Background: Endocrine diseases are characterized by hormonal alterations (excess or defect). Due to the low prevalence (less than five case 5 / 10 000 inhabitants), a large number of them, qualify to be classified as rare diseases such as those of organs like: hypophysis, adrenal glands, gonads as well as some congenital thyroid diseases. Others like Diabetes are considering almost epidemic. Objective: To define the types of diseases observed in the only Endocrinology Clinic in Guyana. Methods: The diagnoses of all patients who attended the endocrinology clinic of the Georgetown Public Hospital Corporation from June 1, 2016 to May 31, 2017, were analyzed. Results: During the one year of this study, approximately 639 patients attended the endocrinology clinic. Of this, 178 patients had thyroid-related diseases with 80 of these having thyrotoxicosis, 49 having hypothyroidism followed by 110 patients with diabetes mellitus. Pituitary tumors were also diagnosed with 2 of acromegaly and 6 of prolactinomas. Cases of hypoadrenalism (n = 5), hypogonadism (n = 4), and pheochromocytoma (n = 6) were not rare; gonadal disease were also found in 17 patients. Thyroid disease was the most frequent diagnosis followed by diabetes mellitus. New emerging endocrine disorders such as hyperlipidemia (n = 1) were rare. Some persons attending the clinic were also noted to be overweight /obese however this was not the primary reason for joining the clinic. Traditional diseases such as Sheehan Syndrome have become rare due to improvements in Obstetric care. 

scholarly journals A closed system irrigation & drainage technique for surgical evacuation of chronic subdural haematomas

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 619 ◽  
Author(s):  
Haider Kareem ◽  
Hadie Adams
Keyword(s):  
Length Of Stay ◽  
Closed System ◽  
Chronic Subdural Haematoma ◽  
Burr Hole ◽  
Ageing Population ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
The One ◽  
Irrigation Drainage ◽  
Drainage Technique

Background: Chronic subdural haematoma (CSDH), is a common neurosurgical disorder that is associated with morbidity and mortality affecting the ageing population. The aim is to present the treatment experience of CSDH patients treated with a technique that combines the classical single burr-hole irrigation and the continuous closed system drainage: The closed system irrigation & drainage (CSID) technique. Methods: The cases undergoing CSDH evacuation with the CSID method were captured over a 4-year period at a tertiary neurosurgical centre. The authors describe the performance of this methods with respect to post-operative clinical and radiological features, including recurrence rates, complications, and length of stay. Results: A total of 36 cases undergoing 42 CSID procedures (30 unilateral and 6 bilateral CSDHs) were performed, in cases ranging between 55-95 years old (median age 79 years). The rate of recurrence or significant ruminant blood in the subdural space on post-operative imaging was 11% (n=4). No cases of pneumocephalus were observed in this series (n=0). The mean (SD) skin-to-skin time for this procedure was 13.4 (4.4) minutes, with a mean (SD) length of stay of 4 (1.9) days. Conclusion: We conclude that the one burr-hole closed system irrigation and drainage technique with a sub-periosteal drain seems to be a simple, effective and safe procedure for treatment of CSDH. It’s well tolerated under local anaesthesia for patients with high co-morbidities and these preliminary results indicated it may potentially be a better option for treatment of CSDH with a lower rate of post-operative complications.

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