Postural Change Assists Surgical Maneuverability During Endoscopic Transsphenoidal Surgery for Pituitary Macroadenoma.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-09 DOI:10.1016/j.wneu.2024.09.079

Yeong Jin Kim, In-Young Kim, Sue Jee Park, Tae-Young Jung, Kyung-Sub Moon, Shin Jung

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引用次数: 0

Abstract

Background: In endoscopic transsphenoidal surgery for pituitary adenoma with suprasellar extension, the prolapse of the stretched floppy diaphragma sellae can obstruct the surgical corridor, posing challenges during pituitary surgery. We introduce a simple postural change technique to mitigate this issue and share our clinical experience.

Methods: Pituitary surgery is performed on an operating table where the patient's position can be adjusted. During transsphenoidal pituitary surgery, raising the patient's head to a Fowler position causes the diaphragma sellae to move upward, whereas lowering the head to a supine position causes it to descend. This simple adjustment minimizes hindrance from the floppy diaphragma sellae during surgery.

Results: We illustrate this technique in pituitary surgery, where diaphragm sellae relocation is necessary.

Conclusions: A simple postural change technique effectively manages prolapsed floppy diaphragma sellae, enhancing visualization and surgical accessibility during endoscopic transsphenoidal pituitary surgery.

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内窥镜经蝶手术治疗垂体大腺瘤时，体位改变有助于手术操作。

背景：在内镜下经蝶窦手术治疗垂体腺瘤并伴有蝶鞍上扩展时，拉伸松弛的蝶鞍膈脱垂会阻塞手术走廊，给垂体手术带来挑战。我们引入了一种简单的体位改变技术来缓解这一问题，并分享我们的临床经验：垂体手术在手术床上进行，病人的体位可以调整。在经蝶垂体手术过程中，将患者头部抬高至 Fowler's 体位会导致蝶鞍膈向上移动，而将头部降低至仰卧位则会导致蝶鞍膈向下移动。这种简单的调整最大程度地减少了手术过程中因膈肌松弛而造成的阻碍：结果：我们在垂体手术中对这一技术进行了说明，因为垂体手术需要重新定位膈肌：结论：简单的体位改变技术可有效处理脱垂的软膈，提高内窥镜经蝶垂体手术的可视性和手术的可及性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.