Contrast study on clinical efficacy between endoscopic and microscopic surgery via transnasal⁃transsphenoidal approach for recurrent nonfunctional pituitary adenoma

Abstract

Objective To compare the clinical efficacy and safety between endoscopic and microscopic surgery via transnasal⁃transsphenoidal approach for recurrent nonfunctional pituitary adenoma, and to explore the best way of operation. Methods The clinical data of 43 patients with recurrent nonfunctional pituitary adenoma who underwent surgery via transnasal ⁃ transsphenoidal approach were analyzed retrospectively from October 2012 to August 2019, including 21 cases of endoscopic surgery (endoscopy group) and 22 cases of microscopic surgery (microscopy group). The bleeding volume during operation, operative time, tumor total resection rate, postoperative symptom remission rate, incidence rate of postoperative complications (including intraoperative cerebrospinal fluid leak, hypophysis function, olfactory disturbance, epistaxis, bleeding in operation area) and tumor recurrence rate were recorded. Results The bleeding volume during operation [(60.67 ± 33.27) ml vs. (111.33 ± 49.26) ml; t = 0.107, P = 0.030] and operation time [(81.77 ± 26.40) min vs. (168.95 ± 45.34) min; t = 0.006, P = 0.000] in the microscopy group were lower than those in the endoscopy group, but there was no significant difference in tumor total resection rate, postoperative symptom remission rate, incidence rate of postoperative complications and tumor recurrence rate ( P > 0.05, for all). Conclusions Neuroendoscopic and microscopic transnasal ⁃ transsphenoidal surgery are two common methods for the treatment of recurrent nonfunctional pituitary adenoma, which can achieve satisfactory results and high safety. The fusion of neuroendoscopy and microscopy is a trend of pituitary adenoma resection.DOI：10.3969/j.issn.1672⁃6731.2020.03.011