OBJECTIVE: To determine, in a systematic review, whether purely endoscopic transsphenoidal resection of pituitary adenomas offers improved outcomes and decreased complications compared to the traditional microscopic approach. DESIGN: Systematic review. SETTING: The literature was searched using Medline, EMBASE, and the Cochrane Library (inception to October 2009) by two independent review authors. METHODS: Studies were included if they compared the two surgical approaches for the management of pituitary adenomas and at least one main outcome measure. MAIN OUTCOME MEASURES: Gross tumour resection (GTR), recurrence, visual field improvement, hormone resolution, mean blood loss, mean operative time, mean hospital length of stay, cerebrospinal fluid (CSF) leak, hormone deterioration, vision deterioration, nasal complications, meningitis, and death. RESULTS: Ten studies met the inclusion criteria (one prospective and nine retrospective) and involved 687 patients. The purely endoscopic approach was associated with less mean blood loss, shorter hospital stays and operative times, and fewer nasal complications. There was also a trend toward better GTR and decreased incidence of postoperative diabetes insipidus. However, a higher incidence of postoperative CSF leak was also noted with the endoscopic approach. Other outcomes and complication rates appeared to be similar between the two groups. CONCLUSIONS: Purely endoscopic transsphenoidal resection of pituitary adenomas seems to be safe and efficacious when compared to the traditional microscopic approach and may offer some benefit.
OBJECTIVE: To determine, in a systematic review, whether purely endoscopic transsphenoidal resection of pituitary adenomas offers improved outcomes and decreased complications compared to the traditional microscopic approach. DESIGN: Systematic review. SETTING: The literature was searched using Medline, EMBASE, and the Cochrane Library (inception to October 2009) by two independent review authors. METHODS: Studies were included if they compared the two surgical approaches for the management of pituitary adenomas and at least one main outcome measure. MAIN OUTCOME MEASURES: Gross tumour resection (GTR), recurrence, visual field improvement, hormone resolution, mean blood loss, mean operative time, mean hospital length of stay, cerebrospinal fluid (CSF) leak, hormone deterioration, vision deterioration, nasal complications, meningitis, and death. RESULTS: Ten studies met the inclusion criteria (one prospective and nine retrospective) and involved 687 patients. The purely endoscopic approach was associated with less mean blood loss, shorter hospital stays and operative times, and fewer nasal complications. There was also a trend toward better GTR and decreased incidence of postoperative diabetes insipidus. However, a higher incidence of postoperative CSF leak was also noted with the endoscopic approach. Other outcomes and complication rates appeared to be similar between the two groups. CONCLUSIONS: Purely endoscopic transsphenoidal resection of pituitary adenomas seems to be safe and efficacious when compared to the traditional microscopic approach and may offer some benefit.
Authors: Reem D Almutairi; Ivo S Muskens; David J Cote; Mark D Dijkman; Vasileios K Kavouridis; Erin Crocker; Kholoud Ghazawi; Marike L D Broekman; Timothy R Smith; Rania A Mekary; Hasan A Zaidi Journal: Acta Neurochir (Wien) Date: 2018-01-06 Impact factor: 2.216
Authors: Khodayar Goshtasbi; Brandon M Lehrich; Mehdi Abouzari; Arash Abiri; Jack Birkenbeuel; Ming-Ying Lan; Wei-Hsin Wang; Gilbert Cadena; Frank P K Hsu; Edward C Kuan Journal: J Neurosurg Date: 2020-03-13 Impact factor: 5.115
Authors: Do Hyun Kim; Yong-Kil Hong; Sin-Soo Jeun; Jae-Sung Park; Soo Whan Kim; Jin Hee Cho; Yong Jin Park; Seon Ik Kim; Sung Won Kim Journal: J Neurol Surg B Skull Base Date: 2018-04-13