Analysis of neuroendoscopic or microscopic transsphenoidal approach in the treatment of pituitary tumors of different grades and the measures to reduce the common postoperative complications

Abstract

Objective To explore the clinical effect of endoscopic assisted or microscopical transsphenoidal surgery in the treatment of different grades of invasive pituitary tumors and the measures to reduce complications. Methods From January 2016 to June 2019, 87 patients with pituitary tumor admitted to the neurosurgery of Tangshan People′s Hospital of Hebei Province were selected as the study objects for retrospective analysis. Among them, 42 patients were included in the endoscopic group and 45 patients were included in the endoscopic group. To compare the related indexes and clinical effects of two different surgical methods, and to analyze the treatment strategies to reduce the common postoperative complications. Results The amount of intraoperative bleeding, the time needed for operation and the hospital stay of patients in endoscopic group were significantly less or shorter than those in microscopical group(intraoperative bleeding volume: (66.19±9.55) ml and (79.78±11.68) ml; operation time: (93.93±9.53) min and (103.33±9.23) min; hospitalization time: (7.71±1.53) d and (10.16±1.33) d). The difference was statistically significant (T values were 5.92, 4.67, 7.94, all P< 0.01). There was no significant difference between the two groups (P= 0.577). There were 2 cases (4.8%) of cerebrospinal fluid leakage in endoscopic group and 12 cases (26.7%) in microscopical group. The difference between the two groups was statistically significant(χ2=5.67, P< 0.05). There were 7 cases (16.7%) of diabetes insipidus in endoscopic group and 22 cases (48.9%) in microscopical group. The difference between the two groups was statistically significant (χ2=5.19, P< 0.05). Conclusion The curative effect of endoscopic transsphenoidal resection of pituitary tumor is similar to that of microscopical resection of pituitary tumor. The patients recover quickly, have fewer complications, and have a short hospital stay. Key words: Neuroendoscopy; Microscope; Pituitary tumor; Complication