Secondary adrenal insufficiency surgery: Difference between revisions
Jump to navigation
Jump to search
| (5 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{ | {{Secondary adrenal insufficiency}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} | ||
==Overview== | ==Overview== | ||
The mainstay of treatment for secondary adrenal insufficiency is [[medical therapy]]. [[Surgery]] is usually reserved for [[tumor]] of the [[pituitary]] which is causing secondary adrenal insufficiency due to [[mass effect]] and is resistant to [[medical therapy]]. | |||
==Surgery== | ==Surgery== | ||
*The mainstay of treatment for secondary adrenal insufficiency is [[medical therapy]]. [[Surgery]] is usually reserved for [[ | *The mainstay of treatment for secondary adrenal insufficiency is [[medical therapy]]. [[Surgery]] is usually reserved for [[tumor]] of the [[pituitary]] which is causing secondary adrenal insufficiency due to [[mass effect]] and is resistant to medical therapy. | ||
*The nature of surgical approach depends on [[patient]] presentation and can be either | *The nature of surgical approach depends on [[patient]] presentation and can be either trans-sphenoidal approach (more common) or open [[craniotomy]]. <ref name="pmid2166068">{{cite journal |vauthors=Arafah BM, Harrington JF, Madhoun ZT, Selman WR |title=Improvement of pituitary function after surgical decompression for pituitary tumor apoplexy |journal=J. Clin. Endocrinol. Metab. |volume=71 |issue=2 |pages=323–8 |year=1990 |pmid=2166068 |doi=10.1210/jcem-71-2-323 |url=}}</ref> | ||
*The outcome is better with [[endoscopic]] trans-sphenoidal surgery when compared to [[microscopic]] technique in gross [[tumor]] removal as it lowers the risk of [[Cerebrospinal fluid|CSF]] leak, septal perforation, [[infection]], [[hematoma]], [[hypopituitarism]], recurrence and overall [[mortality]]. <ref name="pmid28185971">{{cite journal |vauthors=Esquenazi Y, Essayed WI, Singh H, Mauer E, Ahmed M, Christos PJ, Schwartz TH |title=Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas |journal=World Neurosurg |volume=101 |issue= |pages=186–195 |year=2017 |pmid=28185971 |doi=10.1016/j.wneu.2017.01.110 |url=}}</ref><ref name="pmid28104521">{{cite journal |vauthors=Li A, Liu W, Cao P, Zheng Y, Bu Z, Zhou T |title=Endoscopic Versus Microscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenoma: A Systematic Review and Meta-Analysis |journal=World Neurosurg |volume=101 |issue= |pages=236–246 |year=2017 |pmid=28104521 |doi=10.1016/j.wneu.2017.01.022 |url=}}</ref><ref name="pmid24820497">{{cite journal |vauthors=Zhu M, Yang J, Wang Y, Cao W, Zhu Y, Qiu L, Tao Y, Xu Y, Xu H |title=[Endoscopic transsphenoidal surgery versus microsurgery for the resection of pituitary adenomas: a systematic review] |language=Chinese |journal=Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi |volume=49 |issue=3 |pages=236–9 |year=2014 |pmid=24820497 |doi= |url=}}</ref> | *The outcome is better with [[endoscopic]] trans-sphenoidal surgery when compared to [[microscopic]] technique in gross [[tumor]] removal as it lowers the risk of [[Cerebrospinal fluid|CSF]] leak, septal perforation, [[infection]], [[hematoma]], [[hypopituitarism]], recurrence and overall [[mortality]]. <ref name="pmid28185971">{{cite journal |vauthors=Esquenazi Y, Essayed WI, Singh H, Mauer E, Ahmed M, Christos PJ, Schwartz TH |title=Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas |journal=World Neurosurg |volume=101 |issue= |pages=186–195 |year=2017 |pmid=28185971 |doi=10.1016/j.wneu.2017.01.110 |url=}}</ref><ref name="pmid28104521">{{cite journal |vauthors=Li A, Liu W, Cao P, Zheng Y, Bu Z, Zhou T |title=Endoscopic Versus Microscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenoma: A Systematic Review and Meta-Analysis |journal=World Neurosurg |volume=101 |issue= |pages=236–246 |year=2017 |pmid=28104521 |doi=10.1016/j.wneu.2017.01.022 |url=}}</ref><ref name="pmid24820497">{{cite journal |vauthors=Zhu M, Yang J, Wang Y, Cao W, Zhu Y, Qiu L, Tao Y, Xu Y, Xu H |title=[Endoscopic transsphenoidal surgery versus microsurgery for the resection of pituitary adenomas: a systematic review] |language=Chinese |journal=Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi |volume=49 |issue=3 |pages=236–9 |year=2014 |pmid=24820497 |doi= |url=}}</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
| Line 34: | Line 15: | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
Latest revision as of 14:24, 16 November 2017
|
Secondary adrenal insufficiency Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Secondary adrenal insufficiency surgery On the Web |
|
American Roentgen Ray Society Images of Secondary adrenal insufficiency surgery |
|
Risk calculators and risk factors for Secondary adrenal insufficiency surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The mainstay of treatment for secondary adrenal insufficiency is medical therapy. Surgery is usually reserved for tumor of the pituitary which is causing secondary adrenal insufficiency due to mass effect and is resistant to medical therapy.
Surgery
- The mainstay of treatment for secondary adrenal insufficiency is medical therapy. Surgery is usually reserved for tumor of the pituitary which is causing secondary adrenal insufficiency due to mass effect and is resistant to medical therapy.
- The nature of surgical approach depends on patient presentation and can be either trans-sphenoidal approach (more common) or open craniotomy. [1]
- The outcome is better with endoscopic trans-sphenoidal surgery when compared to microscopic technique in gross tumor removal as it lowers the risk of CSF leak, septal perforation, infection, hematoma, hypopituitarism, recurrence and overall mortality. [2][3][4]
References
- ↑ Arafah BM, Harrington JF, Madhoun ZT, Selman WR (1990). "Improvement of pituitary function after surgical decompression for pituitary tumor apoplexy". J. Clin. Endocrinol. Metab. 71 (2): 323–8. doi:10.1210/jcem-71-2-323. PMID 2166068.
- ↑ Esquenazi Y, Essayed WI, Singh H, Mauer E, Ahmed M, Christos PJ, Schwartz TH (2017). "Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas". World Neurosurg. 101: 186–195. doi:10.1016/j.wneu.2017.01.110. PMID 28185971.
- ↑ Li A, Liu W, Cao P, Zheng Y, Bu Z, Zhou T (2017). "Endoscopic Versus Microscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenoma: A Systematic Review and Meta-Analysis". World Neurosurg. 101: 236–246. doi:10.1016/j.wneu.2017.01.022. PMID 28104521.
- ↑ Zhu M, Yang J, Wang Y, Cao W, Zhu Y, Qiu L, Tao Y, Xu Y, Xu H (2014). "[Endoscopic transsphenoidal surgery versus microsurgery for the resection of pituitary adenomas: a systematic review]". Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi (in Chinese). 49 (3): 236–9. PMID 24820497.