ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)
An overview of transsphenoidal surgery in spain from 2018 to 2022
Miguel Paja Fano 1 , Betina Biagetti 2 , Fernando Guerrero-Pérez 3 , Rosa Cámara 4 , Dolores Moure 5 , Felicia Hanzu 6 , M. Angeles Gálvez 7 , Andreu Simó 8 , Rocío Villar 9 , Almudena Vicente 10 , Paola Parra 11 , Patricia Martin-Rojas 11 , Guilermo Serra 12 , Anna Aulinas 13 , Fernando Muñoz 14 , María Calatayud 15 , Marta Araujo-Castro 16 , Soledad Librizzi 16 , Ana Irigaray 17 , Dolores Ollero 17 , Silvia Aznar 18 , Edelmiro Menéndez 19 , Tomás González-Vidal 19 , Javier Abarca 20 , Antonio Pico 21 , Johana Sottile 21 , Rogelio García 22 , Laura González-Fernández 22 , Ana Delgado 23 , Isabel Ortiz 24 , Carmen Tenorio 25 , Cristina Novo 25 , Jose Recio 26 , Nerea Egaña 26 , Pedro De Pablos 27 , Cristina Crespo 28 , David Peñalver 28 , Gonzalo Díaz-Soto 29 , Aina Raventós 30 , Diego Asensio-Wandosell 30 , Manel Puig-Domingo 30 & Alfonso Soto 31
1Basurto University Hospital – OSI Bilbao-Basurto, Endocrinology, Spain; 2Hospital Universitario Vall de Hebron, Endocrinology; 3Hospital Universitari de Bellvitge, Endocrinology; 4Hospital Universitari i Politècnic la Fe, Endocrinology; 5Hospital Universitario de Cruces, Endocrinology; 6Hospital Clinic Barcelona, Endocrinology; 7Hospital Reina Sofía, Endocrinology; 8Hospital Universitario Mutua de Terrassa, Endocrinology; 9Complejo Hospitalario Universitario de Santiago, Endocrinology; 10Complejo Hospitalario de Toledo, Endocrinology; 11Hospital Universitario La Paz, Endocrinology; 12Hospital Universitarito Son Espases, Endocrinology; 13Hospital Sant Pau, Endocrinology; 14Hospital Sant Pau -Hospital del Mar, Neurosurgery; 15Hospital 12 de Octubre, Endocrinology; 16Hospital Universitario Ramon y Cajal, Endocrinology; 17Hospital Universitario de Navarra, Endocrinology; 18Complejo Hospitalario Universitario de Albacete, Endocrinology; 19Hospital Universitario Central de Asturias, Endocrinology; 20Hospital General Universitario de Alicante, Neurosurgery; 21Hospital General Universitario de Alicante, Endocrinology; 22Hospital Gregorio Marañón, Endocrinology; 23Hospital Universitario de Burgos, Endocrinology; 24Hospital Universitario Virgen de las Nieves, Neurosurgery; 25Hospital Universitario Virgen de las Nieves, Endocrinology; 26Hospital Universitario de Salamanca, Endocrinology; 27Hospital Universitario Doctor Negrín, Endocrinology; 28Hospital Universitario Río Hortega, Endocrinology; 29Hospital Clínico Universitario de Valladolid, Endocrinology; 30Hospital German Trías i Pujol, Endocrinology; 31Hospital Virgen del Rocío, Endocrinology
Transsphenoidal surgery (TSS) of the hypothalamic-pituitary region is the approach of choice because of its lower morbidity compared to the transcranial approach. However, its results are highly variable and depend on many factors related to the tumor itself, to the medical team, and to technical issues. We review the situation of this procedure in a nationwide retrospective multicenter evaluation. Data were collected from centers participating in the TESSPAIN (TranssphEnoidal Surgery in SPAIN) registry, that included all TSS performed in each center during a 5-year period (2018-2022). Each center recorded the number of neurosurgeons performing TSS, the technical aspects, the number of procedures/year/surgeon, the pathology operated on, the goals set and their achievement, and the occurrence of long-term complications following the procedure. The 29 centers included performed a total of 2815 TSS procedures. Seventeen centers had more than one dedicated neurosurgeon, four of which had one neurosurgeon performing more than 75% of TSS. Twelve centers had one dedicated neurosurgeon (n:9) or two neurosurgeons who always operated together (n:3). An ENT surgeon always performed the nasal phase of the procedure in 21 of 29 centers, while it was performed by the dedicated neurosurgeon in five centers. In the remaining three centers the ENT surgeon was only required for very complex approaches. No one center averaged more than 40 TSS/year. Only six centers averaged more than 25 TSS/year. Only one center did not use an endoscopic approach. Extended approach to the cavernous sinus was reported by 27 centers. The most common pathology was clinically nonproducing pituitary adenomas (n=1421;50.5%), followed by producing pituitary adenomas (n: 911 (32.4%): 436 GH-producing, 323 Cushing´s disease, 127 prolactinomas and 25 TSH-secreting adenomas). 483 TSS (17.1%) were performed for the treatment of non-adenomatous tumors, usually with extrasellar extension including craniopharyngiomas, RCC, meningiomas, chordomas, and others. The percentage of TSS for nonproducing pituitary adenomas was negatively correlated with the total number of TSS (p:0.016), and the percentage of TSS for non-adenomatous tumors showed a positive correlation with the total number of TSS (p:0.012). TSS in Spain shows an inhomogeneous picture, with a high geographical dispersion and low surgical volume in each center, despite the recommendations of scientific societies. Almost all neurosurgeons use an endoscopic approach and perform a cavernous sinus approach. Centers with higher surgical volume have a higher percentage of TSS for non-adenomatous tumors, while centers with lower surgical volume operate more frequently on nonproducing pituitary adenomas.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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