The learning curve of endoscopic transsphenoidal pituitary surgery

Abstract

Objective To investigate the learning curve of endoscopic transsphenoidal pituitary surgery by comparing the effects of endoscopic transsphenoidal pituitary surgery at different stages.Methods From September 2002 to December 2006,180 patients undergoing endoscopic transsphenoidal pituitary surgery,performed by a single team,were retrospectively evaluated.The patients were divided into groups A to C (n =60) based on the surgery data; operation time,intraoperation blood loss,conversion to microsurgery,total removal,improvement of postoperative vision,complications,and postoperative hospital stay were compared Results No statistical differences were found among the group in age,gender,turnor size,and pathological type; the significant differences were found in the operation time between group A,B,andC (P ＜0.05),but the operation time in group A was significantly longer than that in groups B and C (P ＜0.05).Compared with that in group A,the number of conversion to microsurgery decreased significantly in groups B and C.2 patients in group B and another in group C developed severe postoperative complications.The intraoperation blood loss,total removal,postoperative vision,complications,and postoperative hospital stay showed no differences amongst the three groups.Conclusions Endoscopic transsphenoidal pituitary surgery needs a minimum case-load of 60 patients to help go beyond the steep phase of the learning curve. Key words: Endoscope; Pituitary adenoma; Endonasal transsphenoidal surgery; Learning curve