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Comparison of Short-Term Outcomes Between Endoscopic and Microscopic Trans-Sphenoidal Surgery for the Treatment of Pituitary Adenoma

Li, Jie MD; Ding, Wei MD; Huang, Zheng MD; Xie, Bo Master; Li, Zhen-Yan PhD

doi: 10.1097/SCS.0000000000005676
Clinical Studies

Objective: Until today, it is unclear if endoscopic or microscopic transsphenoidal surgery is the most adequate treatment technique for pituitary adenoma, while microscopic transsphenoidal surgery is termed as a fully-established mechanism that has reasonable performances and is well recognized for addressing adenomas of the pituitary gland. The present research work aims at assessing the short-term results of these surgical methodologies in those patients, who have pituitary adenoma.

Methods: The authors comprehensively searched PubMed, together with EMBASE, and Cochrane Library databases for the purpose of identifying associated investigations. The strength of the relationship was figured out through the calculation of the risk ratio (RR) with corresponding 95% credible interval (95% CI) were put to use for the evaluation of the association.

Results: An aggregate of 17 retrospective studies that involved 1177 participants were included in the present research work. Our results shed light on the fact that endoscopic transsphenoidal surgery was linked to the lower occurrence of diabetes insipidus (RR = 1.42, 95%CI = 1.03-1.98, P = 0.03), fewer septal perforation (RR = 3.16, 95%CI = 1.27-7.85, P = 0.01), and fewer postoperative complications (RR = 1.29, 95% CI = 1.08–1.56, P = 0.006). Moreover, further analyzing indicated no substantial differences existing between the 2 surgical methods in gross tumor removal, meningitis, epistaxis, and cerebrospinal fluid leak.

Conclusion: Endoscopic transsphenoidal surgery reduces diabetes insipidus, septal perforation, and postoperative complications in treating those patients, who have pituitary adenoma. Endoscopic transsphenoidal surgery is worth suggesting as a productive as well as secure process for the treatment of pituitary adenoma.

Neurosurgery, Central South University, Xiangya Hospital, Changsha, China.

Address correspondence and reprint requests to Zhen-Yan Li, PhD, Neurosurgery, Central South University, Xiangya Hospital, Changsha, Hunan, 410000, China; E-mail:

Received 29 March, 2019

Accepted 22 April, 2019

The authors report no conflicts of interest.

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© 2019 by Mutaz B. Habal, MD.