Transsphenoidal Approach for Pituitary Adenomas in Elderly Patients
| Autor: | Elie Alam, Stephanie H Chen, Karthik Madhavan, Simon Buttrick, Zoukaa Sargi, Leon Chieng, Sheikh C. Ali, Annelise C. Sprau, Ricardo J. Komotar |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Tomography Scanners X-Ray Computed Valsalva Maneuver Vision Disorders Hyperlipidemias Nose Neurosurgical Procedures Transsphenoidal approach Resection Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Elderly population Sphenoid Bone medicine Humans In patient Pituitary Neoplasms Aged Aged 80 and over Retrospective review business.industry Incidence (epidemiology) Pituitary tumors Age Factors Endoscopy Middle Aged medicine.disease Magnetic Resonance Imaging humanities Surgery Treatment Outcome 030220 oncology & carcinogenesis Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 121 |
| ISSN: | 1878-8769 |
| Popis: | With a rapidly expanding elderly population in the United States, the incidence of pituitary adenomas in elderly will continue to rise. In this study, we aim to evaluate the safety and efficacy of transsphenoidal endoscopic endonasal resection for pituitary adenomas in the elderly population.A retrospective review of 131 consecutive patients who underwent transsphenoidal endoscopic endonasal resection for pituitary adenomas at the University of Miami Hospital between 2012 and 2016 was performed. Preoperative, intraoperative, and surgical outcomes were analyzed in elderly (70 years) versus nonelderly (70 years) patients.Of the 131 patients, 23 of them were70 years (18%), of which 14 were septuagenarians and 9 were octogenarians. Elderly patients were more likely to present with vision loss (80.8% vs. 56.6%; P = 0.013) and larger tumors on imaging (2.7 ± 1.0 cm vs. 2.4 ± 1.3 cm; P = 0.042). Overall surgical and endocrinologic outcomes between the 2 groups were similar. However, patients70 years old were more likely to have a gross total resection (86.7% vs. 65.4%; P = 0.011), as well as transient diabetes insipidus (54.3% vs. 26.9% P = 0.012) and intraoperative cerebrospinal fluid leak (83.5% vs. 58.5%; P = 0.013). However, permanent postoperative complication rates were similar including rate of permanent diabetes insipidus (4.3% elderly vs. 12.1% adult), cerebrospinal fluid leak (8.7% elderly vs. 8.4% adult), and meningitis (4.3% elderly vs. 2.8% adult). There were no medical complications or deaths in our cohort.The transsphenoidal endoscopic endonasal approach can be a safe and effective technique for resection of pituitary adenomas in patients70 years old with appropriate patient selection. |
| Databáze: | OpenAIRE |
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