3D-Printing Technology Improves Outcomes In Pituitary Adenoma Surgery

Huang X, et al. Pituitary. 2019;doi:10.1007/s11102-018-0927-x.

March 3, 2019

The use of 3D-printed models could lead to less operation time and blood loss and fewer postoperative complications in adults who undergo endoscopic endonasal transsphenoidal surgery for pituitary adenomas and other conditions, according to findings published in Pituitary.

“Several factors influence the outcome of endoscopic endonasal surgery, including the tumor volume, patient age, lesion location and sphenoid pneumatolysis,” Xiaobing Jiang, of the department of neurosurgery at Union Hospital of Tongji Medical College of Huazhong University of Science and Technology in Wuhan, Hubei, China, and colleagues wrote. “An accurate model of the target tumor structure is a major prerequisite for a successful [pituitary adenoma] resection, especially for macroadenomas, as this may avoid disastrous complications due to suboptimal treatment.”

Jiang and colleagues conducted a retrospective analysis of 20 adults who underwent endoscopic endonasal transsphenoidal surgery at Union Hospital in Wuhan. Participants were included based on similar tumor sizes, the presence of no other diseases and nonintuitive tumor identification. All surgeries in the cohort occurred between January and August 2017, with 10 participants (mean age, 44.4 years; 50% women) receiving CT and MRI before surgery; the remaining 10 also received an operation with 3D printing (mean age, 41.2 years; 50% women).

To create the 3D models, images from CT and MRIs were combined. The 3D printer then used this information to create the model, which took between 2 hours, 10 minutes, and 4 hours, 32 minutes, to design and 10 hours, 12 minutes, and 22 hours, 34 minutes, to print.

After surgery, the researchers found that mean operation time was lower in participants who had 3D models compared with participants who did not (127 minutes vs. 143.4 minutes; P = .007). In addition, there was less blood loss in participants with 3D printing compared with participants without (159.9 mL vs. 170 mL; P = .009). The researchers noted that there were postoperative complications in 20% of the 3D-printing group and 40% of the CT and MRI alone group.

“As it is highly precise and allows personalization, 3D-printing technology has started to be applied in medicine in recent years. In neurosurgery, 3D-printing technology can provide models for the patients’ disease characteristics, such as skull defects, brain tumors, intracranial aneurysms and intracranial vascular malformations,” the researchers wrote. “We believe that with its continuous development, 3D-printing technology will be applied in clinical practice in the near future.” – by Phil Neuffer

DisclosuresThe authors report no relevant financial disclosures.

From https://www.healio.com/endocrinology/neuroendocrinology/news/online/%7B582c6512-708a-4900-ad20-f0adb5a79390%7D/3d-printing-technology-improves-outcomes-in-pituitary-adenoma-surgery

Dr. Charles Wilson, One of the world’s greatest neurosurgeons and pioneer of transsphenoidal pituitary surgery died at 88

 

The UCSF website in an obituary from Kate Vidinsky reads “He took a particular interest in pituitary disorders, those affecting the pea-sized ‘master gland’ at the base of the brain responsible for controlling the body’s hormone levels. He was a pioneer of transsphenoidal surgery – the endonasal approach for removing pituitary tumors – and performed more than 3,300 of these procedures at UCSF Medical Center.”

The New York Times in an obituary published yesterday described him as “a pioneering and virtuosic San Francisco neurosurgeon”.

Dr. Wilson died February 28, 2018.

A retrospective analysis of postoperative hypokalemia in pituitary adenomas after transsphenoidal surgery

Abstract.

Background

Pituitary adenoma is one of the most common intracranial neoplasms, and its primary treatment is endoscopic endonasal transsphenoidal tumorectomy. Postoperative hypokalemia in these patients is a common complication, and is associated with morbidity and mortality. This study aimed to analyze the etiopathology of postoperative hypokalemia in pituitary adenomas after endoscopic transsphenoidal surgery.

Methods and Materials

This retrospective study included 181 pituitary adenomas confirmed by histopathology. Unconditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Repeated measures ANOVA was used to analyze change in serum potassium levels at different time points.

Results

Multiple Logistic regression analysis revealed that only ACTH-pituitary adenoma (OR = 4.92, 95% CI [1.18–20.48], P = 0.029) had a significant association with postoperative hypokalemia. Moreover, the overall mean serum potassium concentration was significantly lower in the ACTH versus the non-ACTH group (3.34 mmol/L vs. 3.79 mmol/L, P = 0.001). Postoperative hypokalemia was predominantly found in patients with ACTH-pituitary adenoma (P = 0.033).

Conclusions

ACTH-pituitary adenomas may be an independent factor related postoperative hypokalemia in patients despite conventional potassium supplementation in the immediate postoperative period.

Cite this as

You L, Li W, Chen T, Tang D, You J, Zhang X. (2017) A retrospective analysis of postoperative hypokalemia in pituitary adenomas after transsphenoidal surgery. PeerJ5:e3337 https://doi.org/10.7717/peerj.3337

Read the entire article at https://peerj.com/articles/3337/

Webinar: Endoscopic Endonasal Surgery for the Treatment of Cushing’s Disease

Mon, Jun 13, 2016 11:00 AM – 12:00 PM EDT


Presented by:
Dr. Maria Koutourousiou
Webinar DescriptionAn update on the diagnosis and treatment options of Cushing’s disease. Description of the endoscopic endonasal approach for the management of CD. Surgical videos demonstration and comparison with the microscopic transsphenoidal approach. Surgical outcomes and adjuvant treatment.

Presenter Bio

Dr. Mary Koutourousiou is an attending Neurosurgeon and Assistant Professor at the University of Louisville. She is the Director of the Pituitary and Skull Base Program. Dr. Koutourousiou received her M.D. from the Aristotle University of Thessaloniki, Greece and completed her neurosurgical residency at the General Hospital of Athens “G. Gennimatas”, in Greece. She underwent subspecialty fellowship training in Endoscopic Pituitary Surgery and Minimally Invasive Neurosurgery at the UMC St. Radboud, Nijmegen, in the Netherlands. She moved to the United States in 2010 and completed four years of research and a clinical fellowship in Endoscopic and Open Skull Base Surgery at UPMC Presbyterian in Pittsburgh, Pennsylvania.

Dr. Koutourousiou has published extensively in the field of endoscopic skull base surgery. Her studies have been presented in national and international neurosurgical meetings. Dr. Koutourousiou’s work in skull base surgery has been recognized by the European Skull Base Society and the World Federation of Skull Base Societies.

Register here: https://attendee.gotowebinar.com/register/4982773766837282305?utm_source=newsletter_199&utm_medium=email&utm_campaign=webinar-announcement-endoscopic-endonasal-surgery-for-the-treatment-of-cushing-s-disease

Ohio Pituitary Patient Symposium at OSU and Gentle Giant Awards Dinner

Please join the Pituitary Network Association and The Ohio State University for a Pituitary Patient Symposium featuring a series of pituitary and hormonal patient education seminars presented by some of the top physicians of pituitary and hormonal medicine. The symposium faculty will share the most up-to-date information and be available to answer your most pressing questions.

Following the Patient Symposium you are cordially invited to attend Pituitary Network Association’s Gentle Giant Award Reception and Dinner. Join us in honoring Dr. Daniel Prevedello for his exemplary accomplishments in the field of pituitary medicine.  Dr. Prevedello is an Associate Professor of Neurosurgery at The Ohio State University Wexner Medical center and Director of OSU’S Minimally Invasive Cranial Surgery Program.  Dr. Prevedello is internationally recognized in the field of minimally invasive surgery for brain, pituitary, and skull based tumors and has been a member of Best Doctors of America the last five years.  As a practicing neurosurgeon for over 15 years, Dr. Prevedello has performed over 1,800 procedures of which, over 800 were using the Endoscopic Endonasal Approach.  His current surgical practice encompasses the full spectrum of brain and skull based tumors, both benign and malignant, treated with minimally invasive and conventional approaches.

Registration is available for one or both events. The Patient Symposium registration fee is $30 and includes continental breakfast and lunch*. The Award Reception and Dinner is $50 per person or $80 for two (bring a friend or loved one and receive a discount of $20 on the purchase of 2 tickets).

 

*This registration is for the Patient Symposium only. The Ohio State University is offering a CME Course separate from our Symposium. For information on the CME course go to ccme.osu.edu

Date:  April 18, 2015

Fawcett Event Center
Ohio State University
Columbus, OH

Registration and Continental Breakfast 8:00 – 9:00am

Opening remarks 9:00am – Dr. Prevedello

Pituitary Disorders and the Effects on the Family

Epidemiology of Pituitary Tumors

Defining Clinically Significant Pituitary Disease

Treatment Options: Surgery

State of the Art Surgery for Cushing’s Disease

Question and Answer Session with Morning Symposium Faculty

Lunch with guest patient speakers: Concetta Troskie, Lori Burkhoff

Sexual Dysfunction and Infertility

Acromegaly

Pituitary Trivial Pursuit

Psychosocial Aspects of Pituitary Disease

Pituitary Disease and Your Symptoms

Question and Answer Session with Afternoon Symposium Faculty

Closing Remarks – Dr. Prevedello

Symposium Adjourns 5:45pm

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