Evidence map›Paper›PMID 28185971›Full record

SynthesisWorld neurosurgery2017

Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas.

Yoshua Esquenazi, Walid I Essayed, Harminder Singh, Elizabeth Mauer, Mudassir Ahmed, Paul J Christos, Theodore H Schwartz

Open access · greenAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World neurosurgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 2 pooled it
6.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Yoshua EsquenaziVivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA. Electronic address: Yoshua.EsquenaziLevy@uth.tmc.edu.
Walid I EssayedDepartment of Neurosurgery, Weill Cornell Medical College, Cornell University, New York-Presbyterian Hospital, New York, New York, USA.
Harminder SinghDepartment of Neurosurgery, Weill Cornell Medical College, Cornell University, New York-Presbyterian Hospital, New York, New York, USA; Department of Neurological Surgery, Stanford University School of Medicine, Stanford, California, USA.
Elizabeth MauerHealthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, New York, USA.
Mudassir AhmedDepartment of Neurosurgery, Weill Cornell Medical College, Cornell University, New York-Presbyterian Hospital, New York, New York, USA.
Paul J ChristosDepartment of Neurological Surgery, Stanford University School of Medicine, Stanford, California, USA.
Theodore H SchwartzDepartment of Neurosurgery, Weill Cornell Medical College, Cornell University, New York-Presbyterian Hospital, New York, New York, USA; Department of Otolaryngology, Weill Cornell Medical College, Cornell University, New York-Presbyterian Hospital, New York, New York, USA; Department of Neuroscience, Weill Cornell Medical College, Cornell University, New York-Presbyterian Hospital, New York, New York, USA.
NewYork–Presbyterian Hospital · USCornell University · USNeurological Surgery · USThe University of Texas Health Science Center · US

Funding

Clinical and Translational Science CenterUL1TR000457 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI IMPERATO-MCGINLEY, JULIANNE L · 2012 to 2016
$46.0M
NCATS NIH HHS UL1 TR000457
6 · The paper itself

Abstract

objectiveSurgery for recurrent/residual pituitary adenomas is increasingly being performed through endoscopic surgery. Whether this new technology has altered the indications and outcomes of surgery is unknown. We conducted a systematic review and meta-analysis of published studies to compare the indications and outcomes between microscopic and endoscopic approaches.

methodsA PubMed search was conducted (1985-2015) to identify surgical series of endoscopic endonasal and microscopic transsphenoidal resection of residual or recurrent pituitary adenomas. Data were extracted regarding tumor characteristics, surgical treatment, extent of resection, endocrine remission, visual outcome, and complications.

resultsTwenty-one studies met inclusion criteria. A total of 292 patients were in the endoscopic group, and 648 patients were in the microscopic group. Endoscopic cases were more likely nonfunctional (P < 0.001) macroadenomas (P < 0.001) with higher rates of cavernous sinus invasion (P = 0.012). The pooled rate of gross total tumor resection was 53.5% for the endoscopic group and 46.6% for the microscopic group. Endocrine remission was achieved in 53.0% and 46.7% of patients, and visual improvement occurred in 73.2% and 49.6% for the endoscopic and microscopic groups. Cerebrospinal fluid leak and pituitary insufficiency were higher in the endoscopic group.

conclusionThis meta-analysis indicates that the use of the endoscope to reoperate on residual or recurrent adenomas has only led to modest increases in resection rates. However, larger more complex cases are being tackled, so direct comparisons are misleading. The most dramatic change has been in visual improvement along with modest increases in risk. Reoperation for recurrent or residual adenomas is a safe and effective treatment option.

Indexed as

AdenomaHumansMicrosurgeryNasal CavityNeoplasm Recurrence, LocalNeuroendoscopyPituitary NeoplasmsSphenoid BoneEndonasal endoscopicMicroscopicPituitary adenomaPituitary surgeryRecurrentSkull baseTranssphenoidal

Identifiers

PMID28185971
PMCPMC9119713
OpenAlexW2586505553

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.