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Pituitary surgery’s epidemiology using a national inpatient database in Japan

  • Original Article - Pituitaries
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Abstract

Background

Between 2010 and 2014, microscopic transsphenoidal surgery (mTSS) was performed more frequently than endoscopic TSS (eTSS) in the USA. However, few epidemiological studies on pituitary surgery are currently available.

Methods

We performed a retrospective study on patients who had undergone pituitary surgery between July 2010 and March 2016. To this end, a nationwide inpatient database in Japan was used. Patients’ characteristics, diagnoses, types of surgery, complications, and discharge status were examined.

Results

A total of 16,253 inpatients who received pituitary surgery were identified. Patients were diagnosed with diseases for insurance claims described below: pituitary adenoma, hyperprolactinemia, other pituitary disorders (e.g., Rathke’s cleft cyst), hyperpituitarism, craniopharyngioma, acromegaly, Cushing’s disease, and pituitary cancer. Among them, pituitary adenomas, primarily the non-functioning ones, were the most frequent (66.9%). A total of 14,285 (88%) patients underwent TSS, while 1968 (12%) patients were treated using transcranial surgery. The number of patients undergoing TSS increased each year. The number of eTSS operations was 8140 (77%) and that of mTSS operations was 2419 (23%). Of note, eTSS increased each year. We found that high-volume hospitals more frequently selected eTSS. Compared with mTSS, eTSS was associated with a reduction of hyponatremia incidence (odds ratio, 0.69; p = 0.019). Additionally, it was not associated with other major complications.

Conclusion

The present study showed that both TSS and eTSS increased on a yearly basis. We believe that the present study will be the basis of future epidemiological investigations of pituitary surgery.

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References

  1. Almutairi RD, Muskens IS, Cote DJ, Dijkman MD, Kavouridis VK, Crocker E, Ghazawi K, Broekman MLD, Smith TR, Mekary RA, Zaidi HA (2018) Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis. Acta Neurochir 160:1005–1021. https://doi.org/10.1007/s00701-017-3438-z

    Article  PubMed  Google Scholar 

  2. Ammirati M, Wei L, Ciric I (2013) Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 84:843–849. https://doi.org/10.1136/jnnp-2012-303194

    Article  PubMed  Google Scholar 

  3. Asemota AO, Ishii M, Brem H, Gallia GL (2017) Comparison of complications, trends, and costs in endoscopic vs microscopic pituitary surgery: analysis from a US health claims database. Neurosurgery 81:458–472. https://doi.org/10.1093/neuros/nyx350

    Article  PubMed  Google Scholar 

  4. Broersen LHA, Biermasz NR, van Furth WR, de Vries F, Verstegen MJT, Dekkers OM, Pereira AM (2018) Endoscopic vs. microscopic transsphenoidal surgery for Cushing's disease: a systematic review and meta-analysis. Pituitary 21:524–534. https://doi.org/10.1007/s11102-018-0893-3

    Article  PubMed  PubMed Central  Google Scholar 

  5. Eseonu CI, ReFaey K, Garcia O, Salvatori R, Quinones-Hinojosa A (2018) Comparative cost analysis of endoscopic versus microscopic endonasal transsphenoidal surgery for pituitary adenomas. J Neurol Surg B Skull Base 79:131–138. https://doi.org/10.1055/s-0037-1604484

    Article  PubMed  Google Scholar 

  6. Fathalla H, Cusimano MD, Di Ieva A, Lee J, Alsharif O, Goguen J, Zhang S, Smyth H (2015) Endoscopic versus microscopic approach for surgical treatment of acromegaly. Neurosurg Rev 38:541–548; discussion 548-549. https://doi.org/10.1007/s10143-015-0613-7

    Article  PubMed  Google Scholar 

  7. Hansasuta A, Pokanan S, Punyawai P, Mahattanakul W (2018) Evolution of technique in endoscopic transsphenoidal surgery for pituitary adenoma: a single institution experience from 220 procedures. Cureus 10:e2010. https://doi.org/10.7759/cureus.2010

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ishii Y, Tahara S, Hattori Y, Teramoto A, Morita A, Matsuno A (2015) Fascia patchwork closure for endoscopic endonasal skull base surgery. Neurosurg Rev 38:551–556; discussion 556-557. https://doi.org/10.1007/s10143-015-0614-6

    Article  PubMed  Google Scholar 

  9. Jain V, Chaturvedi A, Pandia MP, Bithal PK (2018) Perioperative course of transsphenoidal pituitary surgery through endoscopic versus microscopic approach: interim concerns for neurosurgical Anesthesiology. J Neurosci Rural Pract 9:336–343. https://doi.org/10.4103/jnrp.jnrp_22_18

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M (1992) Endoscopic pituitary tumor surgery. Laryngoscope 102:198–202. https://doi.org/10.1288/00005537-199202000-00016

    Article  CAS  PubMed  Google Scholar 

  11. Jho HD (2001) Endoscopic transsphenoidal surgery. J Neuro-Oncol 54:187–195

    Article  CAS  Google Scholar 

  12. Jho HD, Carrau RL, Ko Y, Daly MA (1997) Endoscopic pituitary surgery: an early experience. Surg Neurol 47:213–222 discussion 222-213

    Article  CAS  Google Scholar 

  13. Knappe UJ, Moskopp D, Gerlach R, Conrad J, Flitsch J, Honegger JB (2019) Consensus on postoperative recommendations after transsphenoidal surgery. Exp Clin Endocrinol Diabetes 127:29–36. https://doi.org/10.1055/a-0664-7710

    Article  CAS  PubMed  Google Scholar 

  14. Kuo JS, Barkhoudarian G, Farrell CJ, Bodach ME, Tumialan LM, Oyesiku NM, Litvack Z, Zada G, Patil CG, Aghi MK (2016) Congress of neurological surgeons systematic review and evidence-based guideline on surgical techniques and technologies for the management of patients with nonfunctioning pituitary adenomas. Neurosurgery 79:E536–E538. https://doi.org/10.1227/neu.0000000000001390

    Article  PubMed  Google Scholar 

  15. Laine FJ, Nadel L, Braun IF (1990) CT and MR imaging of the central skull base. Part 2. Pathologic spectrum. Radiographics 10:797–821. https://doi.org/10.1148/radiographics.10.5.2217972

    Article  CAS  PubMed  Google Scholar 

  16. Liu JK, Das K, Weiss MH, Laws ER Jr, Couldwell WT (2001) The history and evolution of transsphenoidal surgery. J Neurosurg 95:1083–1096. https://doi.org/10.3171/jns.2001.95.6.1083

    Article  CAS  PubMed  Google Scholar 

  17. Nakajima M, Aso S, Matsui H, Fushimi K, Yasunaga H (2018) Clinical features and outcomes of tetanus: analysis using a National Inpatient Database in Japan. J Crit Care 44:388–391. https://doi.org/10.1016/j.jcrc.2017.12.025

    Article  PubMed  Google Scholar 

  18. Nishioka H (2017) Recent evolution of endoscopic endonasal surgery for treatment of pituitary adenomas. Neurol Med Chir (Tokyo) 57:151–158. https://doi.org/10.2176/nmc.ra.2016-0276

    Article  Google Scholar 

  19. Parasher AK, Workman AD, Kidwai SM, Goljo E, Signore AD, Iloreta AM, Genden EM, Shrivastava R, Navathe A, Govindaraj S (2018) Costs in pituitary surgery: racial, socioeconomic, and hospital factors. J Neurol Surg B Skull Base 79:522–527. https://doi.org/10.1055/s-0038-1635081

    Article  PubMed  PubMed Central  Google Scholar 

  20. Phan K, Xu J, Reddy R, Kalakoti P, Nanda A, Fairhall J (2017) Endoscopic endonasal versus microsurgical transsphenoidal approach for growth hormone-secreting pituitary adenomas-systematic review and meta-analysis. World Neurosurg 97:398–406. https://doi.org/10.1016/j.wneu.2016.10.029

    Article  PubMed  Google Scholar 

  21. Report of Brain Tumor Registry of Japan (1984–2000) (2009) Neurol Med Chir (Tokyo) 49(Suppl):Ps1–P96

    Google Scholar 

  22. Report of Japan Neurosurgery Registry (2015–2017) (2019) Neurol Med Chir (Tokyo) 59:13–81. https://doi.org/10.2176/nmc.si.2019-0001

    Article  Google Scholar 

  23. Rolston JD, Han SJ, Aghi MK (2016) Nationwide shift from microscopic to endoscopic transsphenoidal pituitary surgery. Pituitary 19:248–250. https://doi.org/10.1007/s11102-015-0685-y

    Article  PubMed  PubMed Central  Google Scholar 

  24. Shahlaie K, McLaughlin N, Kassam AB, Kelly DF (2010) The role of outcomes data for assessing the expertise of a pituitary surgeon. Curr Opin Endocrinol Diabetes Obes 17:369–376. https://doi.org/10.1097/MED.0b013e32833abcba

    Article  PubMed  Google Scholar 

  25. Solari D, Zenga F, Angileri FF, Barbanera A, Berlucchi S, Bernucci C, Carapella C, Catapano D, Catapano G, Cavallo LM, D'Arrigo C, de Angelis M, Denaro L, Desogus N, Ferroli P, Fontanella MM, Galzio RJ, Gianfreda CD, Iacoangeli M, Lauretti L, Locatelli D, Locatelli M, Luglietto D, Mazzatenta D, Menniti A, Milani D, Nasi MT, Romano A, Ruggeri AG, Saladino A, Santonocito O, Schwarz A, Skrap M, Stefini R, Volpin L, Wembagher GC, Zoia C, Zona G, Cappabianca P (2019) A survey on pituitary surgery in Italy. World Neurosurg 123:e440–e449. https://doi.org/10.1016/j.wneu.2018.11.186

    Article  PubMed  Google Scholar 

  26. Starke RM, Raper DM, Payne SC, Vance ML, Oldfield EH, Jane JA Jr (2013) Endoscopic vs microsurgical transsphenoidal surgery for acromegaly: outcomes in a concurrent series of patients using modern criteria for remission. J Clin Endocrinol Metab 98:3190–3198. https://doi.org/10.1210/jc.2013-1036

    Article  CAS  PubMed  Google Scholar 

  27. Wada T, Yasunaga H, Horiguchi H, Matsubara T, Fushimi K, Nakajima S, Yahagi N (2016) Outcomes of argatroban treatment in patients with atherothrombotic stroke: observational nationwide study in Japan. Stroke 47:471–476. https://doi.org/10.1161/strokeaha.115.011250

    Article  CAS  PubMed  Google Scholar 

  28. Weber C, Jakola AS, Gulati S, Nygaard OP, Solheim O (2013) Evidence-based clinical management and utilization of new technology in European neurosurgery. Acta Neurochir 155:747–754. https://doi.org/10.1007/s00701-013-1640-1

    Article  PubMed  Google Scholar 

  29. Yamana H, Moriwaki M, Horiguchi H, Kodan M, Fushimi K, Yasunaga H (2017) Validity of diagnoses, procedures, and laboratory data in Japanese administrative data. J Epidemiol 27:476–482. https://doi.org/10.1016/j.je.2016.09.009

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (19AA2007 and H30-Policy-Designated-004), and the Ministry of Education, Culture, Sports, Science and Technology, Japan (17H04141).

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Authors and Affiliations

  1. Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Yujiro Hattori, Shigeyuki Tahara & Akio Morita

  2. Department of Anatomy and Neurobiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

    Yujiro Hattori

  3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Shotaro Aso, Hiroki Matsui & Hideo Yasunaga

  4. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan

    Kiyohide Fushimi

Authors
  1. Yujiro Hattori
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  2. Shigeyuki Tahara
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  4. Hiroki Matsui
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Correspondence to Yujiro Hattori.

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The authors declare no conflicts of interest.

Research involving human participants and/or animals and informed consent

A written informed consent was not required because of the anonymous nature of the data. The Institutional Review Board at the University of Tokyo approved the study (approval no. 3501), and we followed the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Hattori, Y., Tahara, S., Aso, S. et al. Pituitary surgery’s epidemiology using a national inpatient database in Japan. Acta Neurochir 162, 1317–1323 (2020). https://doi.org/10.1007/s00701-020-04270-4

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  • DOI: https://doi.org/10.1007/s00701-020-04270-4

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