Preoperative Stratification of Transsphenoidal Pituitary Surgery Patients Based on Surgical Urgency

Neurosurgery
Hasan A ZaidiEdward R Laws

Abstract

Currently, there is no prioritization scale available to distinguish those patients with pituitary tumors who require urgent surgical intervention from those who are candidates for elective treatment. To develop a classification system that can help primary care physicians, endocrinologists, neurosurgeons, ancillary support staff, and hospital administrators identify high-priority surgical candidates. An expert international panel of clinicians consisting of endocrinologists and neurosurgeons who are involved in the diagnosis and management of sellar disease was convened. The panel retrospectively reviewed individual experiences, including a cohort of patients operated upon for pituitary related disease at the Brigham and Women's Hospital from January 2008 to November 2015. A risk stratification schema was developed to streamline patient care pathways. We identified 4 groups of surgical candidates with varying levels of risk, and then assigned treatment timelines and different differential diagnoses to each. The 4 groups were as follows: group A: urgent-immediate; group B: prompt-initiate treatment within 1 to 2 weeks; group C: soon-initiate treatment within 3 months; group D: elective-as soon as indicated. Among 472 patients t...Continue Reading

References

Nov 1, 1991·Neurosurgery·R M McFadzeanG Teasdale
Sep 1, 1972·Journal of Neurosurgery·R L Rovit, J M Fein
Sep 1, 1982·Surgical Neurology·G Mohr, J Hardy
Aug 1, 1981·Journal of Neurosurgery·S WakaiK Sano
Apr 1, 1995·British Journal of Neurosurgery·M Peter, N De Tribolet
Nov 5, 1997·The Journal of Clinical Endocrinology and Metabolism·A ColaoG Lombardi
Sep 1, 1999·Clinical Endocrinology·H S RandevaJ A Wass
Mar 31, 2001·Headache·T AbeK Sasaki
Sep 11, 2001·The Journal of Clinical Endocrinology and Metabolism·J KreutzerE R Laws
Jan 5, 2002·Journal of the American College of Surgeons·J A Jane, E R Laws
Nov 25, 2003·The New England Journal of Medicine·Annamaria ColaoGaetano Lombardi
Jul 27, 2004·Cancer·Shereen EzzatIan E McCutcheon
Oct 28, 2004·The Journal of Clinical Endocrinology and Metabolism·Massimo TerzoloAnnamaria Colao
Dec 8, 2004·Clinical Endocrinology·John AyukNeil J L Gittoes
Dec 25, 2004·Neurosurgery·Patrick L SempleEdward R Laws
Jan 11, 2005·Surgical Neurology·Deepak Agrawal, Ashok Kumar Mahapatra
Mar 11, 2005·European Journal of Endocrinology·Panagiotis NomikosRudolf Fahlbusch
May 13, 2005·Brain : a Journal of Neurology·M J LevyP J Goadsby
Nov 3, 2005·The Journal of Clinical Endocrinology and Metabolism·Annamaria ColaoRenato Cozzi
May 18, 2006·Endocrine Reviews·Mary P GillamAnnamaria Colao
Aug 5, 2006·Clinical Endocrinology·Felipe F CasanuevaAndrea Giustina
Jun 28, 2007·The Journal of Clinical Endocrinology and Metabolism·Nader PouratianEdward R Laws
Dec 7, 2007·The Journal of Clinical Endocrinology and Metabolism·Chirag G PatilEdward R Laws
Jan 5, 2008·Journal of Neurosurgery·Bernd Markus HofmannRudolf Fahlbusch
May 2, 2008·Journal of Neurosurgery·Patrick L SempleEdward R Laws
May 27, 2008·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Natarajan MuthukumarThiyagarajan Badrinarayanan
Sep 6, 2008·Acta Ophthalmologica·Charlotta Johansson, Bertil Lindblom
Sep 9, 2008·American Journal of Ophthalmology·Maud JacobAlain Vighetto
Apr 30, 2009·Annual Review of Pathology·Sylvia L Asa, Shereen Ezzat
Jan 21, 2010·Endocrine Reviews·Mark SherlockPaul M Stewart
Apr 2, 2010·The New England Journal of Medicine·Anne Klibanski
Jan 5, 2011·The Journal of Clinical Endocrinology and Metabolism·R N ClaytonP W Jones
Feb 8, 2011·The Journal of Clinical Endocrinology and Metabolism·Shlomo MelmedUNKNOWN Endocrine Society
Jul 1, 2011·The Journal of Clinical Endocrinology and Metabolism·John A JaneMary Lee Vance
Oct 13, 2012·Cephalalgia : an International Journal of Headache·Christoph J SchankinAndreas Straube
Sep 21, 2013·Pituitary·George A Scangas, Edward R Laws
Oct 31, 2014·The Journal of Clinical Endocrinology and Metabolism·Laurence KatznelsonJohn A H Wass
Apr 22, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Helen V Danesh-MeyerAndrew H Kaye
Aug 19, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Timothy R SmithEdward R Laws
Oct 21, 2015·Neurosurgery·Paul RizzoliEdward Laws

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.