Comparison of endoscopic and microscopic transsphenoidal pituitary surgery

Abstract

Objective To analyze the outcomes of neuro endoscopic and microscopic pituitary adenoma surgery. Methods A total of 862 cases were enrolled in between October 2010 and October 2011, including 226 cases in endoscopic group and 636 in microscopic group. The extent of tumor resection, visual improvement, operation time and hospitalization days were compared between two groups. Results There was no statistical difference in the extent of tumor resection in microadenomas and giant pituitary adenomas between two groups. While endoscopic surgery resulted in superior resection in macroadenomas. Analyzed by Knosp grading, according to the removal rates, there was no significant difference showed at Knosp level 0-2 and level 4, while endoscopic surgery resulted in superior resection at level 3(P<0.05). The visual acuity and visual field were better in the endoscopic group. The operation time and length of stay in hospitals were both shorter in the endoscopic group than those in the microscopic group. Conclusions Endoscopic transsphenoidal resection of pituitary tumors was safe, with shorter operation time and length of stay. Endoscopic and microscopic transsphenoidal operations had their own advantages, and the advantage of endoscopic transsphenoidal surgery lied in the treatment of invasive adenoma of Knosp 3 grade. Key words: Neuroendoscopes; Microsurgery; Pituitary neoplasms; Prospective studies; Transnasal transsphenoidal approach