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Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women

A recall for histological pseudocapsule (PS) and reappraisal of transsphenoidal surgery (TSS) as a viable alternative to dopamine agonists in the treatment algorithm of prolactinomas are getting vibrant. We hope to investigate the effectiveness and risks of extra-pseudocapsular transsphenoidal surge...

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Autores principales: Chen, Juan, Guo, Xiang, Miao, Zhuangzhuang, Zhang, Zhuo, Liu, Shengwen, Wan, Xueyan, Shu, Kai, Yang, Yan, Lei, Ting
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267792/
https://www.ncbi.nlm.nih.gov/pubmed/35807204
http://dx.doi.org/10.3390/jcm11133920
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author Chen, Juan
Guo, Xiang
Miao, Zhuangzhuang
Zhang, Zhuo
Liu, Shengwen
Wan, Xueyan
Shu, Kai
Yang, Yan
Lei, Ting
author_facet Chen, Juan
Guo, Xiang
Miao, Zhuangzhuang
Zhang, Zhuo
Liu, Shengwen
Wan, Xueyan
Shu, Kai
Yang, Yan
Lei, Ting
author_sort Chen, Juan
collection PubMed
description A recall for histological pseudocapsule (PS) and reappraisal of transsphenoidal surgery (TSS) as a viable alternative to dopamine agonists in the treatment algorithm of prolactinomas are getting vibrant. We hope to investigate the effectiveness and risks of extra-pseudocapsular transsphenoidal surgery (EPTSS) for young women with microprolactinoma, and to look into the factors that influenced remission and recurrence, and thus to figure out the possible indication shift for primary TSS. We proposed a new classification method of microprolactinoma based on the relationship between tumor and pituitary position, which can be divided into hypo-pituitary, para-pituitary and supra-pituitary groups. We retrospectively analyzed 133 patients of women (<50 yr) with microprolactinoma (≤10 mm) who underwent EPTSS in a tertiary center. PS were identified in 113 (84.96%) microadenomas intraoperatively. The long-term surgical cure rate was 88.2%, and the comprehensive remission rate was 95.8% in total. There was no severe or permanent complication, and the surgical morbidity rate was 4.5%. The recurrence rate with over 5 years of follow-up was 9.2%, and a lot lower for the tumors in the complete PS group (0) and hypo-pituitary group (2.1%). Use of the extra-pseudocapsule dissection in microprolactinoma resulted in a good chance of increasing the surgical remission without increasing the risk of CSF leakage or endocrine deficits. First-line EPTSS may offer a greater opportunity of long-term cure for young female patients with microprolactinoma of hypo-pituitary located and Knosp grade 0-II.
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spelling pubmed-92677922022-07-09 Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women Chen, Juan Guo, Xiang Miao, Zhuangzhuang Zhang, Zhuo Liu, Shengwen Wan, Xueyan Shu, Kai Yang, Yan Lei, Ting J Clin Med Article A recall for histological pseudocapsule (PS) and reappraisal of transsphenoidal surgery (TSS) as a viable alternative to dopamine agonists in the treatment algorithm of prolactinomas are getting vibrant. We hope to investigate the effectiveness and risks of extra-pseudocapsular transsphenoidal surgery (EPTSS) for young women with microprolactinoma, and to look into the factors that influenced remission and recurrence, and thus to figure out the possible indication shift for primary TSS. We proposed a new classification method of microprolactinoma based on the relationship between tumor and pituitary position, which can be divided into hypo-pituitary, para-pituitary and supra-pituitary groups. We retrospectively analyzed 133 patients of women (<50 yr) with microprolactinoma (≤10 mm) who underwent EPTSS in a tertiary center. PS were identified in 113 (84.96%) microadenomas intraoperatively. The long-term surgical cure rate was 88.2%, and the comprehensive remission rate was 95.8% in total. There was no severe or permanent complication, and the surgical morbidity rate was 4.5%. The recurrence rate with over 5 years of follow-up was 9.2%, and a lot lower for the tumors in the complete PS group (0) and hypo-pituitary group (2.1%). Use of the extra-pseudocapsule dissection in microprolactinoma resulted in a good chance of increasing the surgical remission without increasing the risk of CSF leakage or endocrine deficits. First-line EPTSS may offer a greater opportunity of long-term cure for young female patients with microprolactinoma of hypo-pituitary located and Knosp grade 0-II. MDPI 2022-07-05 /pmc/articles/PMC9267792/ /pubmed/35807204 http://dx.doi.org/10.3390/jcm11133920 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Juan
Guo, Xiang
Miao, Zhuangzhuang
Zhang, Zhuo
Liu, Shengwen
Wan, Xueyan
Shu, Kai
Yang, Yan
Lei, Ting
Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women
title Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women
title_full Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women
title_fullStr Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women
title_full_unstemmed Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women
title_short Extra-Pseudocapsular Transsphenoidal Surgery for Microprolactinoma in Women
title_sort extra-pseudocapsular transsphenoidal surgery for microprolactinoma in women
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267792/
https://www.ncbi.nlm.nih.gov/pubmed/35807204
http://dx.doi.org/10.3390/jcm11133920
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