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Predictive value of pituitary tumor morphology on outcomes and complications in endoscopic transsphenoidal surgery

World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 321-329页

作者： Andrew T.Heffernan Joseph K.Han John Campbell james reese William G.Day Joshua Edwards Ran V.Singh Wylie Zhu Kent K.Lam Department of Otolaryngology-Head and Neck Surgery Eastern Virginia Medical SchoolNorfolkVirginiaUSA Medical Center Radiologists NorfolkVirginiaUSA Department of Radiology Eastern Virginia Medical SchoolNorfolkVirginiaUSA Sentara Healthcare Analytics and Delivery Science Institute NorfolkVirginiaUSA Neurosurgical Associates NorfolkVirginiaUSA Sentara Neurosurgery Specialists NorfolkVirginiaUSA

Purpose:Endoscopic transsphenoidal surgery(ETSS)is an increasingly utilized approach for resection of pituitary *** studies have evaluated preoperative tumor size,location,and extent as prognostic factors for surgical *** is little data on the relationship between preoperative pituitary tumor radiographic morphology and surgical *** Design:Retrospective longitudinal ***:Single tertiary care *** and Methods:Preoperative magnetic resonance imaging and computed tomography scans from patients undergoing ETSS for pituitary tumor resections from 2007 to 2017 were retrospectively evaluated.A neuroradiologist classified these pituitary tumors into six morphologic groups,each defined by volume,dimensions,extension,and *** difficulty,rates of incomplete resection,and postoperative complications were then stratified in relation to the morphologic ***:Pituitary tumors from 131 patients were classified from preoperative imaging into six characteristic morphologies:(1)microtumor,(2)round,(3)transverse oblong,(4)superior-inferior oblong,(5)bilobed,and(6)large *** that were characterized with the large lobulated,bilobed,and transverse oblong morphologies correlated with higher rates of postoperative evidence of residual tumor(70%,36%,and 47%,respectively,all P<0.002).Likewise,large lobulated,bilobed,and transverse oblong morphologies were also associated with intraoperative cerebrospinal fluid leaks(70%,31%,and 35%,respectively,all P<0.05).Conclusions:We describe a novel descriptive system for the morphology of pituitary tumors that can be determined from preoperative *** tumor morphologic groups are associated with varying degrees of gross tumor resection,complications,and surgical *** pituitary tumor morphology may aid surgeons in planning the extent of resection,need for complex closure,and patient counseling.

关键词： endoscopic transsphenoidal surgery morphology pituitary adenoma pituitary tumor surgical outcomes tumor shape

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