Trends in Endoscopic and Microscopic Approaches to Transsphenoidal Pituitary Surgery in the US.
endoscopic
microscopic
pituitary surgery
skull base surgery
transsphenoidal
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
revised:
15
05
2023
received:
03
03
2023
accepted:
01
06
2023
medline:
11
8
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
ppublish
Résumé
Among the transsphenoidal (TSS) approaches to pituitary tumors, the microscopic approach (MA) has historically been the predominant technique with the increasing adoption of the endoscopic approach (EA). This study investigates national trends in TSS approaches and postoperative outcomes for MA and EA through 2021. The TriNetX database was queried for patients undergoing TSS (MA and EA) between 2010 and 2021. Data were collected on demographics, geographic distribution of surgical centers, postoperative complications, stereotactic radiosurgery (SRT), repeat surgery, and postoperative emergency department (ED) visits. 8644 TSS cases were queried between 2010 and 2021. MA rates were highest until 2013 when rates of EA (52%) surpassed MA (48%) and continued to increase through 2021 (81%). From 2010 to 2015 EA had higher odds of a postoperative CSF leak (OR 3.40) and diabetes insipidus (DI (OR 2.30)) versus MA (p < 0.05); from 2016 to 2021 differences were not significant. Although there was no significant difference among approaches from 2010 to 2015 for syndrome of inappropriate antidiuretic hormone (SIADH), hyponatremia, or bacterial meningitis, from 2016 to 2021 EA had lower odds of SIADH (OR 0.54) and hyponatremia (OR 0.71), and higher odds of meningitis (OR 1.79) versus MA (p < 0.05). EA had higher odds of additional surgery (either EA or MA) after initial surgery from 2010 to 2021. From 2010 to 2015 EA had lower odds of postoperative SRT compared to MA, whereas in 2016-2021 there was no statistical difference among approaches. This study demonstrates increasing EA adoption for TSS in the United States since 2013. Complication rates have overall improved for EA compared to MA, potentially as a result of improving surgeon familiarity and experience. 4 Laryngoscope, 133:2135-2140, 2023.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2135-2140Informations de copyright
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
Références
Liu JK, Das K, Weiss MH, Laws ER, Couldwell WT. The history and evolution of transsphenoidal surgery. J Neurosurg. 2001;95(6):1083-1096.
Doglietto F, Prevedello DM, Jane JA, Han J, Laws ER. A brief history of endoscopic transsphenoidal surgery-from Philipp Bozzini to the first world congress of endoscopic Skull Base surgery. Neurosurg Focus. 2005;19(6):1-6.
Bushe KA, Halves E. Modified technique in transsphenoidal operations of pituitary adenomas. Technical note (author's transl). Acta Neurochir. 1978;41(1-3):163-175.
Halves E, Bushe KA. Transsphenoidal operation on craniopharyngiomas with extrasellar extensions. The advantage of the operating endoscope [proceedings]. Acta Neurochir Suppl. 1979;28(2):362.
Apuzzo ML, Heifetz MD, Weiss MH, Kurze T. Neurosurgical endoscopy using the side-viewing telescope. J Neurosurg. 1977;46(3):398-400.
Rennert RC, Fredrickson VL, Couldwell WT. Microscopic Transsphenoidal surgery in the era of endoscopy: are there any advantages? Otolaryngol Clin North Am. 2022;55(2):411-420.
Jankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M. Endoscopic pituitary tumor surgery. Laryngoscope. 1992;102(2):198-202.
Svider PF, Keeley BR, Husain Q, et al. Regional disparities and practice patterns in surgical approaches to pituitary tumors in the United States. Int Forum Allergy Rhinol. 2013;3(12):1007-1012.
Rolston JD, Han SJ, Aghi MK. Nationwide shift from microscopic to endoscopic transsphenoidal pituitary surgery. Pituitary. 2016;19(3):248-250.
Khalafallah AM, Liang AL, Jimenez AE, et al. Trends in endoscopic and microscopic transsphenoidal surgery: a survey of the international society of pituitary surgeons between 2010 and 2020. Pituitary. 2020;23(5):526-533.
Li A, Liu W, Cao P, Zheng Y, Bu Z, Zhou T. Endoscopic versus microscopic Transsphenoidal surgery in the treatment of pituitary adenoma: a systematic review and meta-analysis. World Neurosurg. 2017;101:236-246.
Fang J, Xie S, Li N, Jiang Z. Postoperative complications of endoscopic versus microscopic Transsphenoidal pituitary surgery: a meta-analysis. J Coll Physic Surg Pak. 2018;28(7):554-559.
Asemota AO, Ishii M, Brem H, Gallia GL. Comparison of complications, trends, and costs in endoscopic vs microscopic pituitary surgery: analysis from a US health claims database. Neurosurgery. 2017;81(3):458-472.
Castaño-Leon AM, Paredes I, Munarriz PM, et al. Endoscopic Transnasal trans-sphenoidal approach for pituitary adenomas: a comparison to the microscopic approach cohort by propensity score analysis. Neurosurgery. 2020;86(3):348-356.
Almutairi RD, Muskens IS, Cote DJ, et al. Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis. Acta Neurochir. 2018;160(5):1005-1021.
Goshtasbi K, Lehrich BM, Abouzari M, et al. Endoscopic versus nonendoscopic surgery for resection of pituitary adenomas: a national database study. J Neurosurg. 2020;134(3):816-824.
Publication Guidelines. TriNetX. https://trinetx.com/real-world-resources/publications/trinetx-publication-guidelines/.
TriNetX - The World's Largest. Living ecosystem of real-world data and evidence. TriNetX. https://trinetx.com/.
Van Gompel JJ, Atkinson JLD, Choby G, et al. Pituitary tumor surgery: comparison of endoscopic and microscopic techniques at a single center. Mayo Clin Proc. 2021;96(8):2043-2057.
Van Gompel JJ, Tabor MH, Youssef AS, et al. Field of view comparison between two-dimensional and three-dimensional endoscopy. Laryngoscope. 2014;124(2):387-390.
Zador Z, Gnanalingham K. Endoscopic transnasal approach to the pituitary - operative technique and nuances. Br J Neurosurg. 2013;27(6):718-726.
Chen C, Hu Y, Lyu L, et al. Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004-2016. Sci Rep. 2021;11(1):15155.
Raappana A, Koivukangas J, Ebeling T, Pirilä T. Incidence of pituitary adenomas in northern Finland in 1992-2007. J Clin Endocrinol Metab. 2010;95(9):4268-4275.
Radhakrishnan K, Mokri B, Parisi JE, O'Fallon WM, Sunku J, Kurland LT. The trends in incidence of primary brain tumors in the population of Rochester, Minnesota. Ann Neurol. 1995;37(1):67-73.
National Trends in Hospital and Physician Adoption of Electronic Health Records. HealthIT.gov https://www.healthit.gov/data/quickstats/national-trends-hospital-and-physician-adoption-electronic-health-records.
Roelfsema F, Biermasz NR, Pereira AM. Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis. Pituitary. 2012;15(1):71-83.
Pollock KJ. Coding and reimbursement for endoscopic Endonasal surgery of the Skull Base - appendices. J Neurol Surg Part B Skull Base. 2019;80(Suppl 2):S255-S264.
Advanced Analytics. TriNetX. Accessed June 11, 2023. https://trinetx.com/real-world-data/advanced-analytics/