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Utility of intraoperative ultrasonography for resection of pituitary adenomas: a comparative retrospective study
- Source :
- Acta Neurochirurgica. 163:1725-1734
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- The evolution of pituitary surgery has made it a safe and effective form of treatment; however, risks of inadequate tumor resection, cerebrospinal fluid (CSF) leak, pituitary dysfunction, and vascular injury still exist. The use of intraoperative ultrasonography (IOUS) in pituitary surgery has been well described. Recent advancements in ultrasound technology have allowed for expanded utility as described here. A retrospective review was performed between January 2016 and December 2019. One hundred thirty-eight patients (mean age 53.7 years, 47% females) were identified undergoing transsphenoidal surgery for pituitary tumors. Thirty-four patients had IOUS performed using a side-firing ultrasound probe, while 104 did not. Data was analyzed for preoperative (demographics, clinical, and radiographic features), perioperative (blood loss, operative time), and postoperative (complications, length of stay, hormone remission, and extent of resection) outcomes. There were no significant differences in patient age, gender, tumor volume, Knosp grade, and hormone-secreting status between the two groups. Patients treated using IOUS had significantly higher rates of gross total resection (79% vs. 44%, p = 0.0008), shorter operative times (74 vs. 146 min, p < 0.0001), lower blood loss (119 vs. 284 cc, p < 0.0001), and hospital stays (2.9 vs. 4.2 days, p = 0.001). Overall complication rates were lower in the IOUS group compared to standard pituitary surgery but did not reach significance. Recent improvements in ultrasound technology have allowed for miniaturization of probes capable of delivering high-resolution images. The use of IOUS in transsphenoidal pituitary surgery may significantly increase rates of gross total resection, while decreasing blood loss, hospital LOS, and operative time.
- Subjects :
- Adenoma
Male
medicine.medical_specialty
medicine.medical_treatment
Operative Time
030218 nuclear medicine & medical imaging
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Humans
Medicine
Pituitary Neoplasms
Retrospective Studies
Ultrasonography
Neuroradiology
Transsphenoidal surgery
Intraoperative Care
medicine.diagnostic_test
business.industry
Pituitary tumors
Interventional radiology
Retrospective cohort study
Perioperative
Length of Stay
Middle Aged
medicine.disease
Surgery
Multivariate Analysis
Female
Neurology (clinical)
Neurosurgery
business
Complication
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 09420940 and 00016268
- Volume :
- 163
- Database :
- OpenAIRE
- Journal :
- Acta Neurochirurgica
- Accession number :
- edsair.doi.dedup.....7c718ed250f4e73e972a1a336b6bd56c