• Domenico Solari, Francesco Zenga, Filippo F Angileri, Andrea Barbanera, Silvia Berlucchi, Claudio Bernucci, Carmine Carapella, Domenico Catapano, Giuseppe Catapano, Luigi M Cavallo, Corrado D'Arrigo, Michelangelo de Angelis, Luca Denaro, Nicola Desogus, Paolo Ferroli, Marco M Fontanella, Renato J Galzio, Cosimo D Gianfreda, Maurizio Iacoangeli, Liverana Lauretti, Davide Locatelli, Marco Locatelli, Davide Luglietto, Diego Mazzatenta, Agazio Menniti, Davide Milani, Maria Teresa Nasi, Antonio Romano, Andrea G Ruggeri, Andrea Saladino, Orazio Santonocito, Andreas Schwarz, Miran Skrap, Roberto Stefini, Lorenzo Volpin, Giulio C Wembagher, Cesare Zoia, Gianluigi Zona, and Paolo Cappabianca.
• Division of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy. Electronic address: domenico.solari@unina.it.
• World Neurosurg. 2019 Mar 1; 123: e440-e449.

BackgroundPituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint.MethodsOn behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions.ResultsOf the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers.ConclusionsDiagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.Copyright © 2018 Elsevier Inc. All rights reserved.

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