Efficacy and safety of cavernous sinus medial wall resection in pituitary adenoma surgery: a systematic review and a single-arm meta-analysis
Authors' conclusion
The cavernous sinus was ruled out, proving the MWCS excision is safe. Limiting population selection to Knosp 3A or lower enhanced GTR frequencies and lowered recurrence, according to subgroup analyses. This meta-analysis shows that MWCS resection can be a beneficial treatment option for pituitary tumors, when there is no macroscopic medial wall invasion and careful patient selection is done, especially for GH- and ACTH-producing tumors that can cause life-threatening metabolic changes.
Study context
- Population
- Patients with pituitary adenomas undergoing resection of the medial wall of the cavernous sinus (CS)8 studies
- Outcome
- Endocrinological remission after MWCS resection
Pooled result
As reported in the abstract
Pooled proportion of endocrinological remission (ER)
Pooled proportion of endocrinological remission (ER)
63.3%
Further pooled results
| Outcome | Values |
|---|---|
| Gross total resection (GTR) | MWCS resection pooled proportion 72.9% |
Subgroups: Knosp 3A or lower
- Limiting selection to Knosp 3A or lower enhanced gross total resection (GTR) frequencies and lowered recurrence
Safety
| Outcome | Values |
|---|---|
| ICA injuryMinimal morbidity | MWCS resection pooled ratio 0.5% |
Original publication
Efficacy and safety of cavernous sinus medial wall resection in pituitary adenoma surgery: a systematic review and a single-arm meta-analysis. Pituitary. Published 29 June 2023. doi:10.
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