Utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery
| Autor: | Lawrence S. Chin, Mayur Jayarao, Anand K. Devaiah |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Endoscope Radiography medicine.medical_treatment Anesthesia General Neurosurgical Procedures Young Adult Postoperative Complications Sphenoid Bone medicine Image Processing Computer-Assisted Humans Pituitary Neoplasms Prolactinoma Optical Fibers Aged Transsphenoidal surgery Postoperative Care medicine.diagnostic_test business.industry Pituitary tumors Magnetic resonance imaging Endoscopy Middle Aged medicine.disease Magnetic Resonance Imaging Craniopharyngioma Surgery Pituitary Hormones ACTH-Secreting Pituitary Adenoma Diabetes insipidus Lasers Gas Female Neurology (clinical) Laser Therapy business Complication Tomography X-Ray Computed |
| Zdroj: | World neurosurgery. 76(1-2) |
| ISSN: | 1878-8769 |
| Popis: | Background This study sought to report on the utility and safety of the flexible-fiber CO 2 laser in endoscopic endonasal transsphenoidal surgery. Methods A retrospective chart review identified 16 patients who underwent laser-assisted transsphenoidal surgery. All tumor pathology types were considered. Results were assessed based on hormone status, tumor size, pathology, complications, and resection rates. Results Sixteen pituitary lesions (pituitary adenomas, 12; Rathke cleft cyst, 2; pituitary cyst and craniopharyngioma, 1 each) with an average size of 22.7 mm were identified by radiographic and pathologic criteria. All patients underwent flexible-fiber CO 2 laser-assisted endoscopic endonasal transsphenoidal surgery. Of the adenomas, 8 were nonsecreting and 4 were secreting (3 prolactinomas and 1 ACTH secreting). Gross total resection was achieved in 7 of 16 patients (43.75%) with hormone remission in all patients (100%) after a mean follow-up of 19.3 months. Postoperative complications occurred in 3 patients (18.75%): 2 patients developed transient diabetes insipidus (DI) and 1 developed a CSF leak requiring surgical repair. Five patients (31.25%) underwent postoperative radiation to the residual lesions. Conclusions We found that CO 2 -laser-assisted endoscopic endonasal transsphenoidal surgery for sellar tumors is a minimally invasive approach using a tool that is quick and effective at cutting and coagulation. The surgery has a low rate of complication, and no laser-related complications were encountered. The laser fiber allows the surgeon to safely cut and coagulate without the line-of-sight problems encountered with conventional CO 2 lasers. Further studies are recommended to further define its role in endoscopic endonasal sellar surgery. |
| Databáze: | OpenAIRE |
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