Pascual José M, Mongardi Lorenzo, Prieto Ruth, Castro-Dufourny Inés, Rosdolsky María, Strauss Sewan, Carrasco Rodrigo, Winter Eduard, Mazzarello Paolo
Department of Neurosurgery, La Princesa University Hospital, C/Diego de León 62, 28006, Madrid, Spain.
Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
Neurosurg Rev. 2017 Oct;40(4):559-575. doi: 10.1007/s10143-017-0864-6. Epub 2017 May 27.
The field of pituitary surgery was born in the first decade of the twentieth century in Europe, and it evolved rapidly with the development of numerous innovative surgical techniques by some of the founding fathers of neurosurgery. This study investigates the pioneering Italian treatise on pituitary surgery, La Patologia Chirurgica dell'Ipofisi (Surgical Pathology of the Hypophysis), published in 1911 by Giovanni Verga (1879-1923), a surgeon from Pavía and one of Golgi's disciples. This little-known monograph compiles the earliest experience on pituitary surgery through the analysis of the first 50 procedures performed between 1903 and 1911. We conducted a biographical survey of Giovanni Verga and the motivations for his work on pituitary surgery. In addition, a systematic analysis of all original reports and historical documents about these pituitary procedures referenced in Verga's treatise was carried out. Verga's treatise provides a summary of the techniques employed and surgical outcomes for the first 50 attempted procedures of pituitary tumor removal. This monograph is the only scientific source that includes a complete account of the series of 10 pituitary tumors operated on by Sir Victor Horsley in the 1900s. Three major types of surgery were employed: (i) palliative procedures of craniectomy (n = 6); (ii) transcranial approaches to the pituitary gland, either subfrontal or subtemporal (n = 13); and (iii) transphenoidal routes to expose the sella turcica, either using an upper transnasal-transethmoidal approach (n = 19) or a lower sublabial/endonasal-transeptal one (n = 12). An operative mortality rate of 36% (n = 17) was observed in these early series. The pathological nature of the tumors operated on was available in 42 cases. There were 28 adenomas and 15 craniopharyngiomas. Sir Victor Horsley (1857-1916) and the Viennese surgeons Anton von Eiselsberg (1860-1939) and Oskar Hirsch (1877-1965) were the leading European figures in the development of pituitary surgery. Giovanni Verga's treatise La Patologia Chirurgica dell'Ipofisi is a fundamental, pioneering book in the history of pituitary surgery, a work that compiles the foundations of this field in Europe and the only authoritative source providing a complete record of pituitary procedures performed by Sir Victor Horsley.
垂体外科领域诞生于20世纪的第一个十年，在欧洲，随着神经外科一些奠基人研发出众多创新手术技术，该领域迅速发展。本研究调查了意大利关于垂体外科的开创性专著《垂体的外科病理学》（La Patologia Chirurgica dell'Ipofisi），该书由来自帕维亚的外科医生乔瓦尼·韦尔加（1879 - 1923）于1911年出版，他是高尔基的弟子之一。这本鲜为人知的专著通过分析1903年至1911年间实施的前50例手术，汇编了垂体外科的早期经验。我们对乔瓦尼·韦尔加进行了生平调查，并探究了他开展垂体外科工作的动机。此外，还对韦尔加专著中引用的所有关于这些垂体手术的原始报告和历史文献进行了系统分析。韦尔加的专著总结了前50例垂体肿瘤切除尝试手术所采用的技术及手术结果。这本专著是唯一一份全面记录20世纪初维克多·霍斯利爵士所做的10例垂体肿瘤手术的科学资料。当时采用了三种主要手术方式：（i）颅骨切除术姑息手术（n = 6）；（ii）经颅垂体入路，包括额下或颞下途径（n = 13）；（iii）经蝶窦途径暴露蝶鞍，采用经鼻 - 筛窦上入路（n = 19）或经唇下/鼻内 - 鼻中隔下入路（n = 12）。在这些早期手术系列中，观察到手术死亡率为36%（n = 17）。42例手术病例的肿瘤病理性质明确。其中有28例腺瘤和15例颅咽管瘤。维克多·霍斯利爵士（1857 - 1916）以及维也纳外科医生安东·冯·艾塞尔伯格（1860 - 1939）和奥斯卡·赫希（1877 - 1965）是垂体外科发展过程中欧洲的领军人物。乔瓦尼·韦尔加的专著《垂体的外科病理学》是垂体外科史上一本重要的开创性著作，它汇集了该领域在欧洲的基础，也是唯一一份全面记录维克多·霍斯利爵士垂体手术的权威资料。
