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The efficacy of a visiting surgical service versus that of a hospital-based surgical service in providing endoscopic endonasal surgery to remove nonfunctioning pituitary adenomas in rural communities

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Abstract

Purpose

To satisfy the increasing demand for endoscopic endonasal approach (EEA) to treat pituitary tumors, especially in rural areas, the “mobile EEA” system, a visiting surgical service, has been established We report this unique system for maintaining community healthcare and evaluate the surgical results of mobile EEA.

Methods

A retrospectively acquired database of 225 consecutive cases of EEA at Shinshu University Hospital (i.e., “home EEA”) and its affiliated hospitals (i.e., “away EEA”) between May 2018 and May 2022 was reviewed. A total of 105 consecutive patients who fulfilled the criterion of a diagnosis of new-onset nonfunctioning pituitary adenoma (PA) were included. Clinical characteristics and postoperative clinical outcomes were statistically compared between the home EEA and away EEA groups to assess the presence of a home advantage and/or an away disadvantage.

Results

Patients were stratified into two cohorts: patients treated at our hospital (home EEA: n = 41 [39.0%]) and those treated in the visiting surgical service at an affiliated hospital (away EEA: n = 64 [61.0%]). Postoperative clinical outcomes, such as the extent of tumor resection (p = 0.39), operation time (p = 0.80), visual function (p = 0.54), and occurrence of surgical complications (p = 0.53), were comparable between the groups. There were no visiting surgical service-related adverse events or accidents caused by physicians’ driving to away hospitals.

Conclusion

Pituitary surgeries performed via the mobile EEA system for nonfunctioning PAs may help maintain local community healthcare. Furthermore, this system can also contribute to the efficient training of surgeons by the same experienced pituitary surgeon using the same protocol.

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Data Availability

All data generated or analyzed during this study are included in this published article.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Toshihiro Ogiwara, Satoshi Kitamura, Tetsuya Goto, Yu Fujii, Ken Yamazaki, Haruki Kuwabara, Akifumi Yokota, Hiromu Murase, Yoshiki Hanaoka, Kazuhiro Hongo & Tetsuyoshi Horiuchi

  2. Department of Neurosurgery, Ina Central Hospital, Ina, Japan

    Atsushi Sato & Kazuhiro Hongo

Authors
  1. Toshihiro Ogiwara
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  2. Satoshi Kitamura
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  3. Tetsuya Goto
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  4. Yu Fujii
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  5. Ken Yamazaki
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  6. Haruki Kuwabara
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  7. Akifumi Yokota
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  8. Hiromu Murase
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  9. Yoshiki Hanaoka
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  10. Atsushi Sato
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  11. Kazuhiro Hongo
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  12. Tetsuyoshi Horiuchi
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Contributions

Author Contributions:　 Conception and Design; T.O., T.G. Acquisition of Data; S.K., Y.F., K.Y., H.K., A.Y., H.M. Analysis and Interpretation of Data, T.O. Drafting the Article, T.O. Reviewed submitted version of manuscript; T.H. Statistical analysis; Y.H. Study supervision; A.S., K.H.

Corresponding author

Correspondence to Toshihiro Ogiwara.

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Ethics Approval

This study was approved by the Shinshu University Ethics Committee (Matsumoto, Japan; approval number: 5679). All procedures were conducted in accordance with the ethical standards of the institutional research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments.

Competing interests

The authors have no competing interests to declare that are relevant to the content of this article.

Competing interests

The authors declare no competing interests.

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Ogiwara, T., Kitamura, S., Goto, T. et al. The efficacy of a visiting surgical service versus that of a hospital-based surgical service in providing endoscopic endonasal surgery to remove nonfunctioning pituitary adenomas in rural communities. Pituitary 26, 521–528 (2023). https://doi.org/10.1007/s11102-023-01338-z

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