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Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience

BACKGROUND: To report the initial experience of surgery for non-functioning pituitary adenoma (NFPA) from a neurosurgeon in a dedicated residency training endoscopic transsphenoidal (ETS) program, and detail the surgical and clinical outcomes during this period. METHODS: A prospective series of all...

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Autores principales: Boetto, Julien, Joitescu, Irina, Raingeard, Isabelle, Ng, Sam, Le Corre, Marine, Lonjon, Nicolas, Crampette, Louis, Favier, Valentin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379140/
https://www.ncbi.nlm.nih.gov/pubmed/35983556
http://dx.doi.org/10.3389/fsurg.2022.959440
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author Boetto, Julien
Joitescu, Irina
Raingeard, Isabelle
Ng, Sam
Le Corre, Marine
Lonjon, Nicolas
Crampette, Louis
Favier, Valentin
author_facet Boetto, Julien
Joitescu, Irina
Raingeard, Isabelle
Ng, Sam
Le Corre, Marine
Lonjon, Nicolas
Crampette, Louis
Favier, Valentin
author_sort Boetto, Julien
collection PubMed
description BACKGROUND: To report the initial experience of surgery for non-functioning pituitary adenoma (NFPA) from a neurosurgeon in a dedicated residency training endoscopic transsphenoidal (ETS) program, and detail the surgical and clinical outcomes during this period. METHODS: A prospective series of all patients operated for NFPA, using an ETS approach, during the three first years of experience of a newly board-certified neurosurgeon was analysed. Clinical, radiological and peri-operative data were collected. Extent of resection (EOR) was determined by formal volumetric analysis. Impact of the learning curve and predictive factors of gross total resection (GTR) were determined. RESULTS: Fifty-three patients with NFPA were included in this prospective cohort which was divided in two periods of time (“First period”: 30 first cases, and “second period”: 23 following cases). Baseline characteristics of the patients in the two periods were similar. Overall occurrence of complication was 22% and was not significantly different in the two periods of time. No patient had severe neurological complication. Gross total resection was achieved in 70% of patients. Mean Extent of resection was 96%. In a multiple linear regression model, a higher EOR was positively correlated with experience (p = 0.018) and negatively correlated with Knosp Score equal to 4 (p < 0.001). Predictive factors for GTR were Higher Knosp grade (p = 0,01), higher pre-operative volume (p = 0.03), and second period of time (p = 0.01). CONCLUSION: NFPA surgery can be safe and efficient during the learning period. Dedicated intensive learning, careful patient selection and multidisciplinary work are key to shorten the learning curve and achieve satisfactory results.
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spelling pubmed-93791402022-08-17 Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience Boetto, Julien Joitescu, Irina Raingeard, Isabelle Ng, Sam Le Corre, Marine Lonjon, Nicolas Crampette, Louis Favier, Valentin Front Surg Surgery BACKGROUND: To report the initial experience of surgery for non-functioning pituitary adenoma (NFPA) from a neurosurgeon in a dedicated residency training endoscopic transsphenoidal (ETS) program, and detail the surgical and clinical outcomes during this period. METHODS: A prospective series of all patients operated for NFPA, using an ETS approach, during the three first years of experience of a newly board-certified neurosurgeon was analysed. Clinical, radiological and peri-operative data were collected. Extent of resection (EOR) was determined by formal volumetric analysis. Impact of the learning curve and predictive factors of gross total resection (GTR) were determined. RESULTS: Fifty-three patients with NFPA were included in this prospective cohort which was divided in two periods of time (“First period”: 30 first cases, and “second period”: 23 following cases). Baseline characteristics of the patients in the two periods were similar. Overall occurrence of complication was 22% and was not significantly different in the two periods of time. No patient had severe neurological complication. Gross total resection was achieved in 70% of patients. Mean Extent of resection was 96%. In a multiple linear regression model, a higher EOR was positively correlated with experience (p = 0.018) and negatively correlated with Knosp Score equal to 4 (p < 0.001). Predictive factors for GTR were Higher Knosp grade (p = 0,01), higher pre-operative volume (p = 0.03), and second period of time (p = 0.01). CONCLUSION: NFPA surgery can be safe and efficient during the learning period. Dedicated intensive learning, careful patient selection and multidisciplinary work are key to shorten the learning curve and achieve satisfactory results. Frontiers Media S.A. 2022-08-02 /pmc/articles/PMC9379140/ /pubmed/35983556 http://dx.doi.org/10.3389/fsurg.2022.959440 Text en © 2022 Boetto, Joitescu, Raingeard, Ng, Le Corre, Lonjon, Crampette and Favier. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Boetto, Julien
Joitescu, Irina
Raingeard, Isabelle
Ng, Sam
Le Corre, Marine
Lonjon, Nicolas
Crampette, Louis
Favier, Valentin
Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience
title Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience
title_full Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience
title_fullStr Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience
title_full_unstemmed Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience
title_short Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience
title_sort endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: learning curve and surgical results in a prospective series during initial experience
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379140/
https://www.ncbi.nlm.nih.gov/pubmed/35983556
http://dx.doi.org/10.3389/fsurg.2022.959440
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