Indications and limitations of endoscopic endonasal surgery

研究成果: ジャーナルへの寄稿評論記事

抄録

The introduction of endoscopy, in conjunction with the technical development of endoscopy such as high definition and 3D, has had a significant impact on the field of endonasal transsphenoidal surgery. Cur­rently, endoscopic surgery is applied for the resection of not only sellar tumors but also parasellar tumors such as anterior skull base tumors, intraorbital tumors, cavernous sinus tumors, infratemporal fossa tumors, clival tumors, and others. Endoscopic endonasal surgery is expected to be used more frequently in the near future. In this paper, based on our own experiences and after reviewing the recent publications, we summarize the indications for endoscopic surgery, focusing on pituitary tumors, craniopharyngiomas, and tuberculum sellae meningiomas. In pituitary tumor surgery, operative results by endoscopic and microscopic surgery are comparable for small tumors located in the sellar, while endoscopic surgery is superior to microscopic surgery for large tumors with extrasellar extension. Fully endoscopic surgery is more likely to be performed for giant pitu­itary adenoma cases for which craniotomy was previously preferred. However, tumors with significant anterior and lateral extension, multilobular suprasellar extension, and firm tumors can be limitations for endoscopic surgery. For craniopharyngiomas, retrochiasmatic tumors extending into the third ventricle can be good candidates for endoscopic surgery. In addition, the tumor-third ventricular relationship in cranio­pharyngiomas is another important factor to consider when deciding upon an indication for endoscopic surgery. The indication for an endoscopic approach for tuberculum sellae meningioma is limited to small anterior midline tumors for the purpose of decompression of the optic apparatus. In summary, although the efficacy of endoscopic surgery is well established, significant suprasellar and lateral extension and vascular encasement can be limitations for endoscopic surgery. For safe and effective endoscopic surgery, patient selection is important depending on the surgeons' operative techniques and experiences. Also, it is important to note that observation and manipulation are different, and it is necessary to acquire surgical techniques to prevent postoperative cerebrospinal fluid leaks.

元の言語英語
ページ(範囲)404-411
ページ数8
ジャーナルJapanese Journal of Neurosurgery
26
発行部数6
DOI
出版物ステータス出版済み - 1 1 2017

Fingerprint

Neoplasms
Craniopharyngioma
Pituitary Neoplasms
Meningioma
Endoscopy
Cavernous Sinus
Third Ventricle
Craniotomy
Skull Base
Decompression
Patient Selection
Blood Vessels
Observation

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

これを引用

Indications and limitations of endoscopic endonasal surgery. / Yoshimoto, Koji; Mukae, Nobutaka; Kuga, Daisuke; Iihara, Koji.

:: Japanese Journal of Neurosurgery, 巻 26, 番号 6, 01.01.2017, p. 404-411.

研究成果: ジャーナルへの寄稿評論記事

@article{04bdb93e5d6f4b47829d5c59306834cc,
title = "Indications and limitations of endoscopic endonasal surgery",
abstract = "The introduction of endoscopy, in conjunction with the technical development of endoscopy such as high definition and 3D, has had a significant impact on the field of endonasal transsphenoidal surgery. Cur­rently, endoscopic surgery is applied for the resection of not only sellar tumors but also parasellar tumors such as anterior skull base tumors, intraorbital tumors, cavernous sinus tumors, infratemporal fossa tumors, clival tumors, and others. Endoscopic endonasal surgery is expected to be used more frequently in the near future. In this paper, based on our own experiences and after reviewing the recent publications, we summarize the indications for endoscopic surgery, focusing on pituitary tumors, craniopharyngiomas, and tuberculum sellae meningiomas. In pituitary tumor surgery, operative results by endoscopic and microscopic surgery are comparable for small tumors located in the sellar, while endoscopic surgery is superior to microscopic surgery for large tumors with extrasellar extension. Fully endoscopic surgery is more likely to be performed for giant pitu­itary adenoma cases for which craniotomy was previously preferred. However, tumors with significant anterior and lateral extension, multilobular suprasellar extension, and firm tumors can be limitations for endoscopic surgery. For craniopharyngiomas, retrochiasmatic tumors extending into the third ventricle can be good candidates for endoscopic surgery. In addition, the tumor-third ventricular relationship in cranio­pharyngiomas is another important factor to consider when deciding upon an indication for endoscopic surgery. The indication for an endoscopic approach for tuberculum sellae meningioma is limited to small anterior midline tumors for the purpose of decompression of the optic apparatus. In summary, although the efficacy of endoscopic surgery is well established, significant suprasellar and lateral extension and vascular encasement can be limitations for endoscopic surgery. For safe and effective endoscopic surgery, patient selection is important depending on the surgeons' operative techniques and experiences. Also, it is important to note that observation and manipulation are different, and it is necessary to acquire surgical techniques to prevent postoperative cerebrospinal fluid leaks.",
author = "Koji Yoshimoto and Nobutaka Mukae and Daisuke Kuga and Koji Iihara",
year = "2017",
month = "1",
day = "1",
doi = "10.7887/jcns.26.404",
language = "English",
volume = "26",
pages = "404--411",
journal = "Japanese Journal of Neurosurgery",
issn = "0917-950X",
publisher = "Japanese Congress of Neurological Surgeons",
number = "6",

}

TY - JOUR

T1 - Indications and limitations of endoscopic endonasal surgery

AU - Yoshimoto, Koji

AU - Mukae, Nobutaka

AU - Kuga, Daisuke

AU - Iihara, Koji

PY - 2017/1/1

Y1 - 2017/1/1

N2 - The introduction of endoscopy, in conjunction with the technical development of endoscopy such as high definition and 3D, has had a significant impact on the field of endonasal transsphenoidal surgery. Cur­rently, endoscopic surgery is applied for the resection of not only sellar tumors but also parasellar tumors such as anterior skull base tumors, intraorbital tumors, cavernous sinus tumors, infratemporal fossa tumors, clival tumors, and others. Endoscopic endonasal surgery is expected to be used more frequently in the near future. In this paper, based on our own experiences and after reviewing the recent publications, we summarize the indications for endoscopic surgery, focusing on pituitary tumors, craniopharyngiomas, and tuberculum sellae meningiomas. In pituitary tumor surgery, operative results by endoscopic and microscopic surgery are comparable for small tumors located in the sellar, while endoscopic surgery is superior to microscopic surgery for large tumors with extrasellar extension. Fully endoscopic surgery is more likely to be performed for giant pitu­itary adenoma cases for which craniotomy was previously preferred. However, tumors with significant anterior and lateral extension, multilobular suprasellar extension, and firm tumors can be limitations for endoscopic surgery. For craniopharyngiomas, retrochiasmatic tumors extending into the third ventricle can be good candidates for endoscopic surgery. In addition, the tumor-third ventricular relationship in cranio­pharyngiomas is another important factor to consider when deciding upon an indication for endoscopic surgery. The indication for an endoscopic approach for tuberculum sellae meningioma is limited to small anterior midline tumors for the purpose of decompression of the optic apparatus. In summary, although the efficacy of endoscopic surgery is well established, significant suprasellar and lateral extension and vascular encasement can be limitations for endoscopic surgery. For safe and effective endoscopic surgery, patient selection is important depending on the surgeons' operative techniques and experiences. Also, it is important to note that observation and manipulation are different, and it is necessary to acquire surgical techniques to prevent postoperative cerebrospinal fluid leaks.

AB - The introduction of endoscopy, in conjunction with the technical development of endoscopy such as high definition and 3D, has had a significant impact on the field of endonasal transsphenoidal surgery. Cur­rently, endoscopic surgery is applied for the resection of not only sellar tumors but also parasellar tumors such as anterior skull base tumors, intraorbital tumors, cavernous sinus tumors, infratemporal fossa tumors, clival tumors, and others. Endoscopic endonasal surgery is expected to be used more frequently in the near future. In this paper, based on our own experiences and after reviewing the recent publications, we summarize the indications for endoscopic surgery, focusing on pituitary tumors, craniopharyngiomas, and tuberculum sellae meningiomas. In pituitary tumor surgery, operative results by endoscopic and microscopic surgery are comparable for small tumors located in the sellar, while endoscopic surgery is superior to microscopic surgery for large tumors with extrasellar extension. Fully endoscopic surgery is more likely to be performed for giant pitu­itary adenoma cases for which craniotomy was previously preferred. However, tumors with significant anterior and lateral extension, multilobular suprasellar extension, and firm tumors can be limitations for endoscopic surgery. For craniopharyngiomas, retrochiasmatic tumors extending into the third ventricle can be good candidates for endoscopic surgery. In addition, the tumor-third ventricular relationship in cranio­pharyngiomas is another important factor to consider when deciding upon an indication for endoscopic surgery. The indication for an endoscopic approach for tuberculum sellae meningioma is limited to small anterior midline tumors for the purpose of decompression of the optic apparatus. In summary, although the efficacy of endoscopic surgery is well established, significant suprasellar and lateral extension and vascular encasement can be limitations for endoscopic surgery. For safe and effective endoscopic surgery, patient selection is important depending on the surgeons' operative techniques and experiences. Also, it is important to note that observation and manipulation are different, and it is necessary to acquire surgical techniques to prevent postoperative cerebrospinal fluid leaks.

UR - http://www.scopus.com/inward/record.url?scp=85021426660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021426660&partnerID=8YFLogxK

U2 - 10.7887/jcns.26.404

DO - 10.7887/jcns.26.404

M3 - Review article

AN - SCOPUS:85021426660

VL - 26

SP - 404

EP - 411

JO - Japanese Journal of Neurosurgery

JF - Japanese Journal of Neurosurgery

SN - 0917-950X

IS - 6

ER -