Endoscopic versus microscopic transsphenoidal pituitary adenoma surgery: a meta-analysis

World Journal of Surgical Oncology

Jiyao Jiang²  Qizhong Luo²  Yong Wang²  Yan Zheng²  Chenyang Dai²  Yang Guo²  Siyi Xu²  Yu Wang¹  Chunlong Zhong²  Yang Gao² 

[1] Department of Obstetrics & Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China;Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

关键词: Microscopic;    Transsphenoidal;    Endoscopic;    Pituitary adenoma;    Meta-analysis;   

Others  :  819919
DOI  :  10.1186/1477-7819-12-94

 received in 2013-08-01, accepted in 2014-03-14,  发布年份 2014

【 摘 要 】

Background

Endoscopic transsphenoidal surgery has gradually come to be regarded as a preferred option in the treatment of pituitary adenomas because of its advantages of improved visualization and its minimal invasiveness. The aim of this study was to compare and evaluate the outcomes and complications of endoscopic and microscopic transsphenoidal surgery in the treatment of pituitary adenomas.

Methods

We performed a systematic literature search of MEDLINE, EMBASE, the Cochrane Library and the Web of Science between January 1992 and May 2013. Studies with consecutive patients that explicitly and fully compared endoscopic and microscopic approaches in the treatment of pituitary adenomas were included.

Results

A total of 15 studies (n = 1,014 patients) met the inclusion criteria among 487 studies that involved endoscopic surgery and 527 studies that dealt with microscopic surgery. The rate of gross tumor removal was higher in the endoscopic group than in the microscopic group. The post-operative rates of septal perforation were less frequent in patients who underwent endoscopic surgery. There was no significant difference between the two techniques in the incidence rates of meningitis, diabetes insipidus, cerebrospinal fluid leak, epistaxis or hypopituitarism. The post-operative hospital stay was significantly shorter for the endoscopic surgery group compared with the microscopic surgery group (P < 0.05). There was no significant difference in the length of the operation (P > 0.05).

Conclusions

The present study indicates that the endoscopic transsphenoidal approach is safer and more effective than microscopic surgery in the treatment of pituitary adenomas.

【 授权许可】

   
2014 Gao et al.; licensee BioMed Central Ltd.

【 图 表 】

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