The anatomical variability of the superficial circumflex iliac artery
Introduction
The superficial circumflex iliac artery (SCIA) is a branch that originates either from the external iliac artery (EIA), or common femoral artery (CFA). Its anatomic variability is particularly relevant in plastic surgery, general surgery, and traumatology/orthopedics.
Material and methods
We retrospectively reviewed 2158 ultrasonographic images of the anterior thigh region from the Republican Medical Diagnostic Center, Functional Diagnosis Department, Chisinau, Republic of Moldova. Rigorous inclusion and exclusion criteria were applied. Additionally, 29 bibliographic sources were reviewed and discussed.
Results
The mean age of the patients was 63.4±10.68 years. In 387 cases (17.93%),SCIA originated from the CFA, while in 1771 cases (82.07%) it emerged from the EIA. SCIA originated from the CFA unilaterally in 194 cases (8.99%) on the left side and 142 cases (6.58%) on the right side, while bilateral origin from the CFA was observed in 51 cases (2.36%)
Discussion
The results in literature were suggestive for a higher prevalence of SCIA origin from the CFA with only one author suggesting the origin of this branch from the EIA, which aligns with our findings. This information is valuable for clinical applications, including hernia repairs, vascular and endovascular surgical interventions, nerve blocks, and skin grafts transplantation.
Conclusions
The most common origin of the SCIA was from the EIA. No significant sex differences were observed, but laterality showed notable variations. Age was analyzed as a factor.
Surgical approaches in pituitary neuroendocrine tumors
Introduction
Pituitary neuroendocrine tumors account for 3.9-7.4/100,000 of central nervous system tumors in the Western world. They are particularly noteworthy, comprising 10-15% of all cases, with a higher prevalence in the 75-79 age group. In the Republic of Moldova, these tumors account for 34% of cases in postmortem examinations while remain an actual theme of discussion in the ENDO WHO congress and are regarded as a factor, which may influence the quality of life (QOL).
Material and methods
We have critically revised 66 literary sources, which were selected using the PubMed library after introducing the keywords “pituitary adenoma surgical approach”.
Results
The main surgical approaches were the transsphenoidal (transnasal, sublabial and endonasal) and transcranial (subfrontal unilateral/bilateral, fronto-lateral, fronto-temporal and median basilar) while the additional surgical approaches were designed for complicated and unusual pituitary neuroendocrine tumors and included combined versions, multiple surgeries or extended approaches. Numerous factors were influential for the selection of a surgical approach concerning the pituitary neuroendocrine tumors. They are not sensible for a type of pituitary neuroendocrine tumor according to the WHO classification while the size of a tumor may dictate its surgical approach.
Conclusion
Each surgical intervention requires a personalized approach and the critical thinking of the surgical team but most of them can be systematically considered before confronting the tumor in an intraoperative environment because most of the preoperative investigations are proven unreliable. There is no established superior surgical approach for each surgical intervention.