A Survey on Pituitary Surgery in Italy

Area of Science:

• Neurosurgery
• Endocrinology
• Oncology

Background:

• Pituitary tumors are diverse and typically benign, requiring a thorough understanding of anatomy, physiology, and pathology for successful management.
• Establishing clear diagnostic and treatment guidelines is essential for optimal patient outcomes.
• A multicenter study was conducted to assess the current neurosurgical practices for pituitary surgery in Italy.

Purpose of the Study:

• To provide an accurate overview of pituitary surgery from a neurosurgical perspective within Italian centers.
• To survey the activities and approaches employed in pituitary surgery across multiple institutions.

Main Methods:

• A survey was distributed to Italian neurosurgical centers participating in pituitary surgery.
• Data was collected from 37 out of 41 public institutions regarding their surgical activities in 2016.
• The survey explored the use of different surgical approaches and the presence of multidisciplinary teams and research facilities.

Main Results:

• A total of 1479 neurosurgical procedures for pituitary tumors were performed in 2016.
• The transsphenoidal approach was predominantly used (1320 cases), with a strong preference for the endoscopic technique (1204 cases).
• Multidisciplinary tumor boards were active in 32 centers, and research laboratories were present in 18 centers.

Conclusions:

• The diagnosis and treatment of pituitary/hypothalamus disorders necessitate a collaborative, multidisciplinary approach.
• The transsphenoidal approach, particularly the endoscopic technique, is confirmed as the primary neurosurgical method for pituitary surgery.
• Centers with multidisciplinary teams, residency programs, and higher surgical volumes are associated with improved patient outcomes.