Search

This article, published in the Journal of Neurological Surgery, presents the findings of a multicenter study on sellar reconstruction techniques after endoscopic transsphenoidal resection of pituitary tumors. The study aimed to identify the most efficient and least morbid surgical approach to sellar reconstruction. The retrospective chart review included 507 patients from 5 participating sites, and variables such as patient demographics, tumor characteristics, reconstruction technique, postoperative CSF leak, and Sino-Nasal Outcome Test (SNOT-22) scores were analyzed. The study found that the effectiveness and morbidity of different sellar reconstruction techniques were comparable, with no significant differences in postoperative complications and SNOT-22 outcomes. Nasoseptal flaps were more commonly used in cases of giant pituitary adenomas and high-flow intraoperative CSF leaks, while mucosal grafts had shorter operating times. The study also reported a low postoperative CSF leak rate in the cohort. [Extracted from the article]

Objectives: Sessile serrated adenomas with dysplasia (SSADs) of the colon are transitional lesions between sessile serrated adenomas (SSAs) and a subset of colorectal adenocarcinomas. We wished to gain insight into the relative percentages and significance of SSAD subtypes.Methods: Retrospective (2007-2012) clinicopathologic review of colorectal polyps initially regarded as having mixed serrated and dysplastic elements. SSADs were subdivided into those with cap-like adenomatous dysplasia (ad1), non-cap-like adenomatous dysplasia (ad2), serrated dysplasia (ser), minimal dysplasia (min), and dysplasia not otherwise specified (nos). MLH1 immunostaining was performed on many.Results: SSADser (7.7%) had a greater propensity for right colon, women, and MLH1 loss vs the entire cohort. SSAad1 (11.6%) had the least female preponderance, was least likely to have MLH1 loss, and was most likely to affect the left colorectum. SSAD with MLH1 loss was associated with an increased burden of SSAs in the background colon (P = .0003) but not tubular adenomas or hyperplastic polyps. Most SSADs (ad2 and nos groups, 80% combined) showed difficult-to-classify dysplasia, intermediate MLH1 loss rates, and intermediate clinical features.Conclusions: While some trends exist, morphologically subclassifying SSADs is probably not justified in routine clinical practice. MLH1 loss portends a greater burden of SSAs in the background colon. [ABSTRACT FROM AUTHOR]