Indocyanine green endoscopic evaluation of pituitary stalk and gland blood flow in craniopharyngiomas.
Craniopharyngioma
Endoscopic endonasal transsphenoidal surgery
Indocyanine green fluorescence
Pituitary function
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
23 Nov 2023
23 Nov 2023
Historique:
received:
28
09
2023
accepted:
18
11
2023
revised:
07
11
2023
medline:
27
11
2023
pubmed:
24
11
2023
entrez:
23
11
2023
Statut:
epublish
Résumé
To assess the use of indocyanine green (ICG) fluorescence endoscopy to evaluate pituitary blood flow in craniopharyngioma resection and its possible impact on intraoperative decisions regarding pituitary stalk processing. Patients with craniopharyngiomas who had undergone transsphenoidal surgery since March 2021, when an ICG endoscope was introduced at the Kagoshima University Hospital, were included in the study. When targeted tumor removal was approaching completion, 10 mg of ICG was administered intravenously to evaluate blood flow in the pituitary stalk and gland. ICG signals and endocrinological status before and after surgery were evaluated retrospectively. Pituitary stalk and gland blood flow were evaluated as positive (++), weakly positive (+), and no signal (-).Ten patients with craniopharyngiomas underwent transsphenoidal surgery using an ICG endoscope (mean age 56.6 ± 14.2 years; 40% male). Among the eight patients in whom the pituitary stalk was preserved, pituitary function with positive signal on the stalk was intact in two. Two other patients with weakly positive stalk and positive pituitary gland signals showed intact function or minimal pituitary dysfunction. Four patients had impairments in more than three axes with poor ICG signals in the stalk or pituitary gland. Two patients underwent pituitary amputation because of high tumor invasion and lack of ICG signal in the stalk after tumor removal, resulting in panhypopituitarism. A negative ICG signal in the pituitary stalk is likely to indicate postoperative pituitary function loss. Craniopharyngioma surgery using ICG endoscopy may be useful for predicting endocrine prognosis and improving tumor outcomes.
Identifiants
pubmed: 37996551
doi: 10.1007/s10143-023-02223-w
pii: 10.1007/s10143-023-02223-w
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
312Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Carmel PW, Antunes JL, Chang CH (1982) Craniopharyngiomas in children. Neurosurgery 11:382–389. https://doi.org/10.1227/00006123-198209000-00008
doi: 10.1227/00006123-198209000-00008
pubmed: 7133354
Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551. https://doi.org/10.3171/jns.1998.89.4.0547
doi: 10.3171/jns.1998.89.4.0547
pubmed: 9761047
Müller HL (2014) Craniopharyngioma. Endocr Rev 35:513–543. https://doi.org/10.1210/er.2013-1115
doi: 10.1210/er.2013-1115
pubmed: 24467716
Hofmann BM, Höllig A, Strauss C, Buslei R, Buchfelder M, Fahlbusch R (2012) Results after treatment of craniopharyngiomas: further experiences with 73 patients since 1997. J Neurosurg 116:373–384. https://doi.org/10.3171/2011.6.JNS081451
doi: 10.3171/2011.6.JNS081451
pubmed: 21942724
Morisako H, Goto T, Goto H, Bohoun CA, Tamrakar S, Ohata K (2016) Aggressive surgery based on an anatomical subclassification of craniopharyngiomas. Neurosurg Focus 41:E10. https://doi.org/10.3171/2016.9.FOCUS16211
doi: 10.3171/2016.9.FOCUS16211
pubmed: 27903115
Yamada S, Fukuhara N, Oyama K, Takeshita A, Takeuchi Y, Ito J, Inoshita N (2010) Surgical outcome in 90 patients with craniopharyngioma: an evaluation of transsphenoidal surgery. World Neurosurg 74:320–330. https://doi.org/10.1016/j.wneu.2010.06.014
doi: 10.1016/j.wneu.2010.06.014
pubmed: 21492566
Bobeff EJ, Mathios D, Mistry AA et al (2023) Predictors of extent of resection and recurrence following endoscopic endonasal resection of craniopharyngioma. J Neurosurg:1–12. https://doi.org/10.3171/2023.3.JNS222607
Litvack ZN, Zada G, Laws ER (2012) Indocyanine green fluorescence endoscopy for visual differentiation of pituitary tumor from surrounding structures. J Neurosurg 116:935–941. https://doi.org/10.3171/2012.1.JNS11601
doi: 10.3171/2012.1.JNS11601
pubmed: 22360574
Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 101:3888–3921. https://doi.org/10.1210/jc.2016-2118
doi: 10.1210/jc.2016-2118
pubmed: 27736313
Kinoshita Y, Tominaga A, Usui S, Arita K, Sakoguchi T, Sugiyama K, Kurisu K (2013) The arginine and GHRP-2 tests as alternatives to the insulin tolerance test for the diagnosis of adult GH deficiency in Japanese patients: a comparison. Endocr J 60:97–105. https://doi.org/10.1507/endocrj.ej12-0230
doi: 10.1507/endocrj.ej12-0230
pubmed: 23079545
Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM (2008) Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 108:715–728. https://doi.org/10.3171/JNS/2008/108/4/0715
doi: 10.3171/JNS/2008/108/4/0715
pubmed: 18377251
Fujio S, Hanada T, Yonenaga M, Nagano Y, Habu M, Arita K, Yoshimoto K (2021) Surgical aspects in craniopharyngioma treatment. Innov Surg Sci 6:25–33. https://doi.org/10.1515/iss-2019-1004
doi: 10.1515/iss-2019-1004
pubmed: 34966836
Duff JM, Meyer FB, Ilstrup DM, Laws ER Jr, Schleck CD, Scheithauer BW (2000) Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46:291–302; discussion 302. https://doi.org/10.1097/00006123-200002000-00007
doi: 10.1097/00006123-200002000-00007
pubmed: 10690718
Lin LL, El Naqa IE, Leonard JR, Park TS, Hollander AS, Michalski JM, Mansur DB (2008) Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1:126–130. https://doi.org/10.3171/PED/2008/1/2/126
doi: 10.3171/PED/2008/1/2/126
pubmed: 18352781
Tomita T, Bowman RM (2005) Craniopharyngiomas in children: surgical experience at Children’s Memorial Hospital. Childs Nerv Syst 21:729–746. https://doi.org/10.1007/s00381-005-1202-9
doi: 10.1007/s00381-005-1202-9
pubmed: 16044343
Park YS, Chang JH, Park YG, Kim DS (2011) Recurrence rates after neuroendoscopic fenestration and gamma Knife surgery in comparison with subtotal resection and gamma Knife surgery for the treatment of cystic craniopharyngiomas. J Neurosurg 114:1360–1368. https://doi.org/10.3171/2009.9.JNS09301
doi: 10.3171/2009.9.JNS09301
pubmed: 19877807
Takano S, Akutsu H, Mizumoto M, Yamamoto T, Tsuboi K, Matsumura A (2015) Neuroendoscopy followed by radiotherapy in cystic craniopharyngiomas—a long-term follow-up. World Neurosurg 84:1305–15.e1. https://doi.org/10.1016/j.wneu.2015.06.022
doi: 10.1016/j.wneu.2015.06.022
pubmed: 26100163
Ordóñez-Rubiano EG, Forbes JA, Morgenstern PF et al (2018) Preserve or sacrifice the stalk? Endocrinological outcomes, extent of resection, and recurrence rates following endoscopic endonasal resection of craniopharyngiomas. J Neurosurg:1–9. https://doi.org/10.3171/2018.6.JNS18901
Amano K, Aihara Y, Tsuzuki S, Okada Y, Kawamata T (2019) Application of indocyanine green fluorescence endoscopic system in transsphenoidal surgery for pituitary tumors. Acta Neurochir (Wien) 161:695–706. https://doi.org/10.1007/s00701-018-03778-0
doi: 10.1007/s00701-018-03778-0
pubmed: 30762125
Inoue A, Kohno S, Ohnishi T et al (2021) Tricks and traps of ICG endoscopy for effectively applying endoscopic transsphenoidal surgery to pituitary adenoma. Neurosurg Rev 44:2133–2143. https://doi.org/10.1007/s10143-020-01382-4
doi: 10.1007/s10143-020-01382-4
pubmed: 32889658
Hide T, Yano S, Shinojima N, Kuratsu J (2015) Usefulness of the indocyanine green fluorescence endoscope in endonasal transsphenoidal surgery. J Neurosurg 122:1185–1192. https://doi.org/10.3171/2014.9.JNS14599
doi: 10.3171/2014.9.JNS14599
pubmed: 25723307
Muto J, Mine Y, Nishiyama Y et al (2023) Intraoperative real-time near-infrared image-guided endoscopic endonasal surgery for pituitary tumors. World Neurosurg 175:e218–e229. https://doi.org/10.1016/j.wneu.2023.03.055
doi: 10.1016/j.wneu.2023.03.055
pubmed: 36924890