■无功能的垂体腺瘤(NFPA)是分化良好的良性肿瘤,起源于垂体的腺垂体细胞。他们出现头痛,视觉障碍,或颅神经缺陷。NFPA可以复发,进展,或作为残留肿瘤存在。我们,因此,进行了这篇综述,以比较修正手术和立体定向手术对肿瘤大小的影响,视觉状态,内分泌状态,和并发症。
■对已发表的关于复发性,残余,或从开始到2020年6月接受重做手术或立体定向放射外科手术的进展NFPA是根据系统评价和荟萃分析指南的首选报告项目进行的。包括13个记录(1209名患者),使用随机效应荟萃分析模型对每项研究中估计的风险比(RR)和95%置信区间(CIs)进行汇总.
■与立体定向放射外科(SRS)相比,重做手术是肿瘤体积较大的患者的首选干预措施,在减小肿瘤体积方面更有效(风险比[RR]56.14;95%CI,16.45-191.58)。与SRS相比,翻修手术的视力丧失更多(风险比[RR]0.08;95%CI,0.03-0.20)。然而,SRS与较少的并发症相关,比如新的尿崩症,与重做手术相比(风险比[RR]0.01;95%CI0.01-0.03)。
■如果肿瘤体积较大,并且需要通过减积立即减少肿瘤负担,则重做手术是治疗复发性/残留或进展性NFPA的最佳选择。然而,重做手术与较高的视力丧失风险相关,新的内分泌疾病,和其他并发症,与SRS相反。
UNASSIGNED: Non-functioning pituitary adenomas (NFPAs) are well-differentiated benign tumors originating from the adenohypophyseal cells of the pituitary gland. They present with headaches, visual disorders, or cranial nerve deficits. NFPAs can recur, progress, or present as residual tumors. We, therefore, conducted this
review to compare the effects of both revision surgery and stereotactic surgery on tumor size, visual status, endocrine status, and complications.
UNASSIGNED: A systematic
review of published literature on recurrent, residual, or progressing NFPAs that underwent redo surgery or stereotactic radiosurgery from the inception till June 2020 was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirteen records (1209 patients) were included, and risk ratio (RR) and 95% confidence intervals (CIs) estimated from each study were pooled using a random-effects meta-analysis model.
UNASSIGNED: Redo surgery was the preferred intervention in patients presenting with larger tumor sizes and was more effective in reducing the tumor size as compared to stereotactic radiosurgery (SRS) (risk ratio [RR] 56.14; 95% CI, 16.45-191.58). There was more visual loss with revision surgery as compared to SRS (risk ratio [RR] 0.08; 95% CI, 0.03-0.20). However, SRS was associated with fewer complications, such as new diabetes insipidus, as compared to the redo surgery (risk ratio [RR] 0.01; 95% CI 0.01-0.03).
UNASSIGNED: Redo surgery is the superior choice in the treatment of recurrent/residual or progressing NFPAs if the tumor size is large and an immediate reduction in tumor burden through debulking is warranted. However, redo surgery is associated with a higher risk of visual loss, new endocrinopathies, and other complications, in contrast to SRS.