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Utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery.
World Neurosurg. 2011 Jul-Aug; 76(1-2):149-55.WN

Abstract

BACKGROUND

This study sought to report on the utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery.

METHODS

A retrospective chart review identified 16 patients who underwent laser-assisted transsphenoidal surgery. All tumor pathology types were considered. Results were assessed based on hormone status, tumor size, pathology, complications, and resection rates.

RESULTS

Sixteen pituitary lesions (pituitary adenomas, 12; Rathke cleft cyst, 2; pituitary cyst and craniopharyngioma, 1 each) with an average size of 22.7 mm were identified by radiographic and pathologic criteria. All patients underwent flexible-fiber CO2 laser-assisted endoscopic endonasal transsphenoidal surgery. Of the adenomas, 8 were nonsecreting and 4 were secreting (3 prolactinomas and 1 ACTH secreting). Gross total resection was achieved in 7 of 16 patients (43.75%) with hormone remission in all patients (100%) after a mean follow-up of 19.3 months. Postoperative complications occurred in 3 patients (18.75%): 2 patients developed transient diabetes insipidus (DI) and 1 developed a CSF leak requiring surgical repair. Five patients (31.25%) underwent postoperative radiation to the residual lesions.

CONCLUSIONS

We found that CO2-laser-assisted endoscopic endonasal transsphenoidal surgery for sellar tumors is a minimally invasive approach using a tool that is quick and effective at cutting and coagulation. The surgery has a low rate of complication, and no laser-related complications were encountered. The laser fiber allows the surgeon to safely cut and coagulate without the line-of-sight problems encountered with conventional CO2 lasers. Further studies are recommended to further define its role in endoscopic endonasal sellar surgery.

Authors+Show Affiliations

Department of Neurosurgery, Boston Medical Center, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21839966

Citation

Jayarao, Mayur, et al. "Utility and Safety of the Flexible-fiber CO2 Laser in Endoscopic Endonasal Transsphenoidal Surgery." World Neurosurgery, vol. 76, no. 1-2, 2011, pp. 149-55.
Jayarao M, Devaiah AK, Chin LS. Utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. World Neurosurg. 2011;76(1-2):149-55.
Jayarao, M., Devaiah, A. K., & Chin, L. S. (2011). Utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. World Neurosurgery, 76(1-2), 149-55. https://doi.org/10.1016/j.wneu.2010.10.038
Jayarao M, Devaiah AK, Chin LS. Utility and Safety of the Flexible-fiber CO2 Laser in Endoscopic Endonasal Transsphenoidal Surgery. World Neurosurg. 2011 Jul-Aug;76(1-2):149-55. PubMed PMID: 21839966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. AU - Jayarao,Mayur, AU - Devaiah,Anand K, AU - Chin,Lawrence S, PY - 2010/05/09/received PY - 2010/08/31/revised PY - 2010/10/19/accepted PY - 2011/8/16/entrez PY - 2011/8/16/pubmed PY - 2011/10/7/medline SP - 149 EP - 55 JF - World neurosurgery JO - World Neurosurg VL - 76 IS - 1-2 N2 - BACKGROUND: This study sought to report on the utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. METHODS: A retrospective chart review identified 16 patients who underwent laser-assisted transsphenoidal surgery. All tumor pathology types were considered. Results were assessed based on hormone status, tumor size, pathology, complications, and resection rates. RESULTS: Sixteen pituitary lesions (pituitary adenomas, 12; Rathke cleft cyst, 2; pituitary cyst and craniopharyngioma, 1 each) with an average size of 22.7 mm were identified by radiographic and pathologic criteria. All patients underwent flexible-fiber CO2 laser-assisted endoscopic endonasal transsphenoidal surgery. Of the adenomas, 8 were nonsecreting and 4 were secreting (3 prolactinomas and 1 ACTH secreting). Gross total resection was achieved in 7 of 16 patients (43.75%) with hormone remission in all patients (100%) after a mean follow-up of 19.3 months. Postoperative complications occurred in 3 patients (18.75%): 2 patients developed transient diabetes insipidus (DI) and 1 developed a CSF leak requiring surgical repair. Five patients (31.25%) underwent postoperative radiation to the residual lesions. CONCLUSIONS: We found that CO2-laser-assisted endoscopic endonasal transsphenoidal surgery for sellar tumors is a minimally invasive approach using a tool that is quick and effective at cutting and coagulation. The surgery has a low rate of complication, and no laser-related complications were encountered. The laser fiber allows the surgeon to safely cut and coagulate without the line-of-sight problems encountered with conventional CO2 lasers. Further studies are recommended to further define its role in endoscopic endonasal sellar surgery. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/21839966/Utility_and_safety_of_the_flexible_fiber_CO2_laser_in_endoscopic_endonasal_transsphenoidal_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(10)00825-9 DB - PRIME DP - Unbound Medicine ER -