Resumen
Introduction: This is a review of the surgical techniques and outcomes of patients who underwent pituitary adenoma resection over a period of 6 years. Objectives: To compare surgical results between endoscopically assisted microsurgery and the purely microscopic or endoscopic technique. Methodology. Retrospective data were collected from patients with pituitary adenoma operated from 2013 to 2019. Results. A total of 30 patients underwent pituitary adenoma resection with endoscopy-assisted microsurgery performed by the same surgical team. Transoperatively, 36.6% developed a cerebrospinal fluid fistula. The most common postoperative complication was diabetes insipidus in 18 patients and 1 patient had septal perforation. Total gross resection was achieved in 26 (86.6%) patients. Conclusion. The endoscope-assisted microsurgery technique allows successful resection of pituitary tumors, being effective and safe, with high percentages of resection and fewer complications.
Citas
Al-Mefty, O., Pravdenkova, S., & Gragnaniello, C. A technical note on endonasal combined microscopic endoscopic with free head navigation technique of removal of pituitary adenomas. Neurosurgical Review, 2010; 33(2): 243–248. https://doi.org/10.1007/s10143-010-0241-1
O’Malley, B. W., Grady, M. S., Gabel, B. C., Leibowitz, J. M., Heuer, G. G., Bohman, L.-E., … Pisapia, J. Comparison of endoscopic and microscopic removal of pituitary adenomas: single-surgeon experience and the learning curve. Neurosurgical Focus, 2008, 25(6), E10. https://doi.org/10.3171/foc.2008.25.12.e10
Razak, A. A., Horridge, M., Connolly, D. J., Warren, D. J., Mirza, S., Muraleedharan, V., & Sinha, S. Comparison of endoscopic and microscopic trans-sphenoidal pituitary surgery: early results in a single centre. British Journal of Neurosurgery, 2013; 27(1): 40–43. https://doi.org/10.3109/02688697.2012.703353
Catapano, D., Sloffer, C.A., Frank, G., Pasquini, E., D’Angelo, V. a, & Lanzino, G. Comparison between the microscope and endoscope in the direct endonasal extended transsphenoidal approach: anatomical study. Journal of Neurosurgery, 2006. 104(3), 419–425. https://doi.org/10.3171/jns.2006.104.3.419
McLaughlin, N., Eisenberg, A. A. Cohan, P., Chaloner, Ch, B. & Kelly, D.F. Value of endoscopy for maximizing tumor removal in endonasal transsphenoidal pituitary adenoma surgery. J. Neurosurg. 2013, (March), 118(3): 613–620. https://doi.org/10.3171/2012.11.JNS112020
Bošnjak, R., Benedi, M., Boršoš, I., & Urban, J. Image-guided navigation in transnasal surgery of pituitary adenomas. = Nevronavigacija pri transnazalnih operacijah hipofiznih adenomov. Endosskipska revija, 2009. 14(30), 11–15. http://www.dlib.si/details/URN:NBN:SI:DOC-HM3HWRPO/?query=%27contributor%3DBor%C5%A1o%C5%A1%2C+Imre%27&pageSize=25&language=eng
Ostrom, Q. T., Gittleman, H., Liao, P., Rouse, C., Chen, Y., Dowling, J., Wolinsky, Y., Kruchko, C., Barnholtz-Sloan, J. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2007–2011. Neuro-Oncology, 2014; Oct. 16, (Suppl. 4): iv1-iv63. https://doi.org/10.1093/neuonc/nou223
Cho, C. H., Barkhoudarian, G., Hsu, L., Bi, W. L., Zamani, A. A., & Laws, E. R. Magnetic resonance imaging validation of pituitary gland compression and distortion by typical sellar pathology. Journal of Neurosurgery, 2013, Dec.; 119(6): 1461–1466. https://doi.org/10.3171/2013.8.JNS13496
Bi, W.L., Dunn, I.F., Laws, E.R.Jr. Chapter 16 - Pituitary surgery. In: Jameson, J.L., DeGroot, L.J., eds. Endocrinology: Adult & Pediatric. 7th ed. Philadelphia: Elsevier; 2015. Pp. 275-290. https://doi.org/10.1016/B978-0-323-18907-1.00016-0
Murad, M.H., Fernández-Balsells, M.M., Barwise, A. Gallegos-Orozco, J.F., Paul, A., Lane, M.A., Lampropulos, J.F., Natividad, I., Perestelo-Pérez, L., Ponce de León-Lovatón, P.G., Albuquerque, F.N., Carey J., Erwin, P.J., Montori, V.M. Outcomes of surgical treatment for nonfunctioning pituitary adenomas: a systematic review and meta-analysis. Clinical Endocrinology, 2010, Dec. 73(6), 777–791. https://doi.org/10.1111/j.1365-2265.2010.03875.x
Kassam, A.B., Prevedello, D.M., Carrau, R.L., Snyderman, C.H., Thomas, A., Gardner, P., Zanation, A., Duz, B., Stefko, T., Byers, K., Horowitz, M.B. Endoscopic endonasal skull base surgery: analysis of complications in the authors’ initial 800 patients, J. Neurosurg. 2011, June; 114(6): 1544–1568. https://doi.org/10.3171/2010.10.JNS09406
Rotenberg, B., Tam, S., Ryu, W. H. A., & Duggal, N. Microscopic Versus Endoscopic Pituitary Surgery: A Systematic Review. The Laringoscope, 2010, Jul; 120(7): 1292–1297. https://doi.org/10.1002/lary.20949
Karppinen, A., Ritvonen, E., Setälä, K., Niemelä, M., Tikkanen, E., Kivipelto, L., … Schalin-Jäntti, C. Transition from Microscopic to Endoscopic Transsphenoidal Surgery for Nonfunctional Pituitary Adenomas. World Neurosurgery 2015, Jul.; 84(1): 48-57. https://doi.org/10.1016/j.wneu.2015.02.024
Ammirati, M., Wei, L., & Ciric, I. Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: A systematic review and meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry. 2013, Aug; 84(8): 843–849. https://doi.org/10.1136/jnnp-2012-303194
Laws, E. R., & Barkhoudarian, G. The transition from microscopic to endoscopic transsphenoidal surgery: The experience at Brigham and women’s hospital. World Neurosurgery, 2014, Dec.; 82(6): S152–S154. https://doi.org/10.1016/j.wneu.2014.07.035
Neal, J.G., Patel, S.J., Kulbersh, J.S., Osguthorpe, J.D., Schlosser, R.J. Comparison of techniques for transsphenoidal pituitary surgery. Am J Rhinol, 2007, Mar-Apri; 21(2): 203–206. https://doi.org/10.2500/ajr.2007.21.2981
Copyright
License
Copyright (c) 2019 Daniela María López Santos y José Enrique Azmitia Springmuhl

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish in this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License 4.0 (CC BY-NC_SA 4.0) that indicates: a) It is allowed that others share the work, with an acknowledgement of the work's authorship and initial publication in this journal, b) The work may not be used for commercial purposes, c) If it's remixed, transformed, or built upon the material, one must distribute the contributions under the same license as the original
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository, website or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.