A Survey on Pituitary Surgery in Italy.

Adenoma / epidemiology Central Nervous System Cysts / epidemiology Craniopharyngioma / epidemiology Humans Italy / epidemiology Needs Assessment Neurosurgical Procedures / statistics & numerical data Patient Care Team / organization & administration Pituitary Gland / surgery Pituitary Neoplasms / epidemiology

Craniopharyngiomas Endoscopic endonasal surgery Multidisciplinary team Pituitary adenomas Pituitary surgery Pituitary/hypothalamus Transsphenoidal surgery

Journal

World neurosurgery

ISSN: 1878-8769

Titre abrégé: World Neurosurg

Pays: United States

ID NLM: 101528275

Informations de publication

Date de publication:
Mar 2019

Historique:

received: 02 08 2018

revised: 19 11 2018

accepted: 20 11 2018

pubmed: 1 12 2018

medline: 2 4 2019

entrez: 1 12 2018

Statut: ppublish

Résumé

Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint. On behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions. Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers. Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

On behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions.

RESULTS RESULTS

Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers.

CONCLUSIONS CONCLUSIONS

Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.

Identifiants

DOI: 10.1016/j.wneu.2018.11.186 PMID: 30500583

pubmed: 30500583

pii: S1878-8750(18)32745-1

doi: 10.1016/j.wneu.2018.11.186

pii:

doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

e440-e449