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A microscope and endoscope assisted transsphenoidal pituitary adenoma resection complications compared with meta-analysis

Author: WeiZhanLiang
Tutor: TanYuanFu
School: Guangxi Medical University
Course: Neurosurgery
Keywords: microsurgery resection treatment transnasal transsphenoidal endoscopic complication pituitary adenoma
CLC: R736.4
Type: Master's thesis
Year: 2012
Downloads: 45
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Abstract


BACKGROUND：Nowadays, There’re lots of literatures about the outcomesand comparisons between the transnasal approach assists with the microscopyand endoscopy for the treatment of pituitary adenomas, but the relatedmeta-analysis is sparse.OBJECTIVE: We performed a meta-analysis of reported series of thetransnasal surgery assists with the microscopy（MS） and endoscopy（ES） forthe treatment of pituitary adenomas to explore the advantages anddisadvantages between group MS and group ES.METHODS: The Online databases，such as PubMed, Medline, Ovid andSpringer link, were searched for English-language articles reportingquantifiable outcome data published between1980and2011pertaining to thesurgical treatment of pituitary adenomas. The references listed in each articleof interest were also reviewed for pertinent articles. All the literatures whichmeet the inclusion criteria were sorted and analysed, then a meta-analysis wasmade.RESULTS: Of all the literatures meet the inclusion criteria, twelve studiesdescribing3721patients having tansnasal surgery with the microscopy andfourteen studies describing2991patients having tansnasal surgery with theendoscopy. The outcomes from the meta-analysis were that the Clinical curerate was68.23%（2539/3721) and the complication rate was15.80%(588/3721) in the microscopy group; while76.58%(1854/2421) and12.10%(362/2991) in the endoscopy group.CONCLUSION: Despite the inherent limitations in this study, we find that theClinical cure rate in the endoscopy group was significantly higher comparedwith the microscope group[OR=1.422，(95%CI：1.265~1.599)；P<0.005], andthe complication rate after the surgery was lower than the microscopegroup[(OR=0.734，(95%CI：0.637~0.845)；P<0.005). Therefore, theendoscopy is priority selection for the transnasal approach of the pituitaryadenomas resection.

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CLC: > Medicine, health > Oncology > Internal endocrine tumors > Pituitary tumor
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