Management of Cushing's Disease: Changing Trend from Microscopic to Endoscopic Surgery

Cushing's disease (CD) is a spectrum of clinical manifestations due to adrenocorticotropic hormone–secreting pituitary adenoma. Transsphenoidal adenomectomy remains the standard treatment. There has been a paradigm shift from microscopic to endoscopic transsphenoidal surgery in recent years. Ho...

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Bibliographic Details
Published in:World neurosurgery 2020-02, Vol.134, p.e46-e54
Main Authors: Bora, Santanu Kumar, Suri, Ashish, Khadgawat, Rajesh, Tandon, Nikhil, Suri, Vaishali, Chand Sharma, Mehar, Satyarthee, Gurudutt, Singh, Manmohan, Tandon, Vivek, Agarwal, Deepak, Kumar, Rajinder, Chandra, P. Sarat, Gurjar, Hitesh Kumar, Borkar, Sachin, Gupta, Deepak Kumar, Singh, Pankaj Kumar, Kale, Shashank Sharad
Format: Article
Language:English
Subjects:
ACTH
ACTH-Secreting Pituitary Adenoma - surgery
Adolescent
Adult
Child
Cushing disease
Endonasal
Endoscopy
Female
Humans
Hydrocortisone - blood
Hypercortisolism
Male
Middle Aged
Neuroendoscopy
Neurosurgical Procedures - adverse effects
Pituitary ACTH Hypersecretion - surgery
Pituitary Neoplasms - surgery
Postoperative Period
Remission
Remission Induction - methods
Retrospective Studies
Transsphenoidal
Treatment Outcome
Young Adult
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Summary:Cushing's disease (CD) is a spectrum of clinical manifestations due to adrenocorticotropic hormone–secreting pituitary adenoma. Transsphenoidal adenomectomy remains the standard treatment. There has been a paradigm shift from microscopic to endoscopic transsphenoidal surgery in recent years. However, the efficacy of endoscopic transsphenoidal surgery has not been established. Therefore, it is of interest to determine the superiority of endoscopic transsphenoidal surgery, if any, over microscopic surgery. To assess the efficacy of endoscopic endonasal transsphenoidal surgery for the treatment of CD and to determine the factors affecting remission. Patients undergoing surgery for CD from 2009 to 2017 were analyzed retrospectively. Transsphenoidal resection was the preferred treatment, with recent trends in favor of the endonasal endoscopic skull base approach. Postoperative cortisol level of
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2019.08.165