Outcomes of endoscopic endonasal surgery for pediatric craniopharyngioma with a focus on morphological preservation of the pituitary stalk and endocrine functions.
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引用次数: 0
Abstract
Purpose: Preservation of endocrine function in pediatric patients with craniopharyngioma is crucial. However, few reports of endoscopic endonasal surgery (EES) for pediatric craniopharyngiomas with intending endocrine function preservation exist. This study aimed to identify the outcomes of EES with intending preservation of pituitary stalk in pediatric patients with craniopharyngioma.
Methods: Data from 22 pediatric patients with craniopharyngioma who underwent 35 EESs between 2011 and 2022 were retrospectively assessed. The tumor location (infradiaphragmatic [ID] or supradiaphragmatic [SD]) and endocrine functions were evaluated. The patients were divided into two groups: those with preoperatively preserved some endocrine function (Group P) and already completely lost endocrine function (Group ACL). Morphological preservation of the pituitary stalk (MPPS) and postoperative endocrine functional outcomes were analyzed only in the cases of Group P. Tumor recurrence was evaluated in all patients.
Results: In the 35 EESs, the tumors were ID in 17 cases and SD in 18. Twenty-five cases were included in Group P and 10 in Group ACL. In Group P, MPPS was achieved in 18 (72%) cases, and postoperative preservation of some endocrine function was achieved in 14 (77.8%) of the MPPS cases. ID tumor (P < 0.001) and intraoperative MPPS (P < 0.001) were associated with postoperative preservation of some endocrine function. Intraoperative MPPS (P = 0.044) was a significantly associated risk factor for tumor recurrence.
Conclusions: In EES for pediatric craniopharyngiomas, postoperative preservation of some endocrine function is achievable in ID tumors with MPPS. Therefore, preservation of endocrine function should be attempted in cases of ID tumors. However, clinicians should be aware that MPPS increases the risk of tumor recurrence.
期刊介绍：
Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease.
The journal considers:
Biology of Pituitary Tumors
Mechanisms of Pituitary Hormone Secretion
Regulation of Pituitary Function
Prospective Clinical Studies of Pituitary Disease
Critical Basic and Clinical Reviews
Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.
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