Endocrine and surgical outcomes after medial cavernous sinus wall resection for functioning pituitary adenomas: a systematic review and meta-analysis.
Luis O Vargas, Vratko Himic, Vagif Kazimli et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the outcomes of selective medial cavernous sinus wall resection (MCSWR) in adults with functioning pituitary adenomas (FPAs). Analyzing data from 13 studies involving 493 patients, the pooled endocrine remission (ER) rate was 85%, and gross total resection (GTR) was 92%. Recurrence rates were low at 6%.
Key findings
- Pooled endocrine remission rate after MCSWR was 85% (95% CI: 77-91%).
- Gross total resection rate was 92% (95% CI: 81-97%).
- Recurrence rate was 6% (95% CI: 3-13%).
- Complications included cranial nerve palsies in 3% and postoperative CSF leaks in 4%.
Why it matters
Understanding the effectiveness and safety of MCSWR for FPAs is crucial for optimizing treatment strategies. High rates of endocrine remission and low recurrence suggest that this approach may benefit selected patients, enhancing clinical outcomes.
What to keep in mind
Most studies had a serious or critical risk of bias, primarily due to confounding factors and single-arm designs.