[Curative effect analysis of two surgical methods for removal of pituitary adenoma via endonasal transsphenoidal approach].

ABSTRACT

Objective: To compare the efficacy of endoscopic endonasal transsphenoidal surgery and microsurgery for pituitary adenomas. Methods: One hundred and ten patients with pituitary adenoma who were treated by single nostril transsphenoidal surgery in the department of neurosurgery of the First Affiliated Hospital of Bengbu Medical College from June 2014 to December 2016 were enrolled.These cases were randomly divided into endoscopic group 53 cases (including 36 cases of functional pituitary adenoma and 17 cases of non-functional pituitary adenoma) and microscope group 57 cases (including 34 cases of pituitary adenoma and 23 cases of non-functional pituitary adenomas), with no significant difference in preoperative clinical data about gender, age, tumor size and endocrine function (P>0.05). The total tumor resection rate, postoperative complication rate and the rate of functional tumor hormone levels were compared between the two groups. Results: The total resection rate of tumor in patients with endoscope and microscope group were 75.5% (40/53) and 70.2% (40/57) without statistically significant difference (P>0.05). The total resection rate and hormone level decline effective rate of functional pituitary adenomas in neuroendoscope group (91.7%, 33/36; 83.3%, 30/36) were higher than those in microscope group (70.6%, 24/34; 61.8%, 21/34) with statistically significant difference (P<0.05). Another side, there was no statistically significant difference in total resection of non-functional pituitary adenomas between endoscope group (41.2%, 7/17) and microscope group (69.6%, 16/23) (P>0.05). The total incidence of postoperative complications in endoscopic group (9.4%, 5/53) was lower than that in the microscope group (24.6%, 14/57), with statistically significant difference (P<0.05), in which the rate of postoperative complications of functional pituitary adenomas and nonfunctional pituitary adenoma in endoscopy group (8.3%, 3/36; 11.8%, 2/17) and in microscope (20.6%, 7/34; 30.4%, 7/23) had no statistical significance (P>0.05). Conclusion: Pituitary adenoma resection rate in two ways had no obvious difference, but the advantages of endoscopic surgery for functional pituitary adenomas were obvious.The incidence of postoperative complications of endoscopic surgery was lower than that of microscopic surgery, but there was no difference between functional and non-functional tumors.