Pituitary Society Delphi Survey: An international perspective on endocrine management of patients undergoing transsphenoidal surgery for pituitary adenomas
Por:
Tritos NA, Fazeli PK, McCormack A, Mallea-Gil SM, Pineyro MM, Christ-Crain M, Frara S, Labadzhyan A, Ioachimescu AG, Shimon I, Takahashi Y, Gurnell M, Fleseriu M, Valassi E., Wierman, Margaret E.
Publicada:
1 feb 2022
Ahead of Print:
1 jul 2021
Resumen:
Purpose In adults and children, transsphenoidal surgery (TSS) represents the cornerstone of management for most large or functioning sellar lesions with the exception of prolactinomas. Endocrine evaluation and management are an essential part of perioperative care. However, the details of endocrine assessment and care are not universally agreed upon. Methods To build consensus on the endocrine evaluation and management of adults undergoing TSS, a Delphi process was used. Thirty-five statements were developed by the Pituitary Society's Education Committee. Fifty-five pituitary endocrinologists, all members of the Pituitary Society, were invited to participate in two Delphi rounds and rate their extent of agreement with statements pertaining to perioperative endocrine evaluation and management, using a Likert-type scale. Anonymized data on the proportion of panelists' agreeing with each item were summarized. A list of items that achieved consensus, based on predefined criteria, was tabulated. Results Strong consensus (>= 80% of panelists rating their agreement as 6-7 on a scale from 1 to 7) was achieved for 68.6% (24/35) items. If less strict agreement criteria were applied (ratings 5-7 on the Likert-type scale), consensus was achieved for 88% (31/35) items. Conclusions We achieved consensus on a large majority of items pertaining to perioperative endocrine evaluation and management using a Delphi process. This provides an international real-world clinical perspective from an expert group and facilitates a framework for future guideline development. Some of the items for which consensus was not reached, including the assessment of immediate postoperative remission in acromegaly or Cushing's disease, represent areas where further research is needed.
Filiaciones:
Tritos NA:
Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
Fazeli PK:
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
McCormack A:
Garvan Institute of Medical Research, Darlinghurst, Australia
Mallea-Gil SM:
Hospital Militar Central, Buenos Aires, Argentina
Pineyro MM:
Hospital de Clinicas, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
Christ-Crain M:
University Hospital Basel, Basel, Switzerland
Frara S:
Università Vita-Salute San Raffaele, Milano, Italy
Labadzhyan A:
Cedars-Sinai Medical Center, Los Angeles, CA, USA
Ioachimescu AG:
Emory University School of Medicine, Atlanta, GA, USA
Shimon I:
Rabin Medical Center, Petah Tikva, Israel
Takahashi Y:
Nara Medical University, Nara, Japan
Gurnell M:
Wellcome-MRC Institute of Metabolic Science, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Box 289, Cambridge, CB2 0QQ, UK.
Fleseriu M:
Oregon Health & Science University, Portland, OR, USA.
Valassi E.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Wierman, Margaret E.:
VA Medical Center, United States
Open Access
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