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What is the current clinical practice in pituitary adenoma surgery in Europe? European Pituitary Adenoma Surgery Survey (EU-PASS) results—technical part
Neurosurgical Review ( IF 2.5 ) Pub Date : 2021-08-02 , DOI: 10.1007/s10143-021-01614-1
Martin Májovský 1 , Andre Grotenhuis 2 , Nicolas Foroglou 3 , Francesco Zenga 4 , Sebastien Froehlich 5 , Florian Ringel 6 , Nicolas Sampron 7 , Nick Thomas 8 , Martin Komarc 9, 10 , David Netuka 1
Affiliation  

Pituitary adenoma surgery has evolved rapidly in recent decades, changing clinical practice markedly and raising new challenges. There is no current consensus or guidelines for perioperative care that includes possible complication management. This study aims to determine current practice across European neurosurgical centres. We created a list of eligible departments performing pituitary adenoma surgery based on cooperation with EANS, national neurosurgical societies, and personal communication with local neurosurgeons. We contacted the chairpersons from each department and asked them (or another responsible neurosurgeon) to fill out the survey. The survey consisted of 58 questions. For further analysis, departments were divided into subgroups: “academic”/ “non-academic centre”, “high-volume”/“low-volume”, “mainly endoscopic”/ “mainly microscopic”/ “mixed practise”, and by geographical regions. Data from 254 departments from 34 countries were obtained. The average time to complete the survey was 18 min. Notably, the endoscopic approach is the predominant surgical approach in Europe, used in 56.8% of the centres. In routine cases without intraoperative cerebrospinal fluid leak, high-volume centres are less pedantic with sellar closure when compared with low-volume centres (p < 0.001). On the other hand, when a postoperative cerebrospinal fluid leak occurs, high-volume centres are more active and indicate early reoperation (p = 0.013). Less than 15% of the participating centres perform early postoperative MRI scans. Marked variation was noted among different groups of respondents and some contentious issues are discussed. Such information can encourage useful debate about the reasons for the variations seen and perhaps help develop standardised protocols to improve patient outcomes. A future research focus is to compare European results with other regions.



中文翻译:

目前欧洲垂体腺瘤手术的临床实践是什么?欧洲垂体腺瘤手术调查 (EU-PASS) 结果——技术部分

近几十年来垂体腺瘤手术发展迅速,显着改变了临床实践并提出了新的挑战。目前还没有关于围手术期护理的共识或指南,包括可能的并发症管理。本研究旨在确定欧洲神经外科中心的当前实践。我们根据与 EANS、国家神经外科学会的合作以及与当地神经外科医生的个人交流,创建了一份符合条件的科室进行垂体腺瘤手术。我们联系了每个部门的主席,并请他们(或另一位负责的神经外科医生)填写调查表。该调查包括 58 个问题。为了进一步分析,部门被分为子组:“学术”/“非学术中心”、“高容量”/“低容量”、“主要是内窥镜”/“主要是微观”/“混合实践”,并按地理区域划分。获得了来自 34 个国家的 254 个部门的数据。完成调查的平均时间为 18 分钟。值得注意的是,内窥镜方法是欧洲主要的手术方法,在 56.8% 的中心使用。在没有术中脑脊液漏的常规病例中,与低容量中心相比,高容量中心在关闭鞍区时不那么迂腐。p  < 0.001)。另一方面,当发生术后脑脊液漏时,高容量中心更活跃,表明早期再手术 ( p  = 0.013)。不到 15% 的参与中心进行术后早期 MRI 扫描。注意到不同受访者群体之间存在显着差异,并讨论了一些有争议的问题。此类信息可以鼓励对所见差异的原因进行有益的辩论,并可能有助于制定标准化协议以改善患者结果。未来的研究重点是将欧洲的结果与其他地区进行比较。

更新日期:2021-08-02
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