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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic pituitary surgery: a systematic review and meta-analysis
Abtin Tabaee1, Vijay K Anand, Yolanda Barrón
1Department of Otolaryngology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, NY 10003, USA. atabaee@hotmail.com
Journal of Neurosurgery
|February 10, 2009
Summary
Endoscopic pituitary surgery is safe and effective for short-term outcomes, including tumor removal and hormone resolution. This meta-analysis of nine studies supports its use, though long-term tumor control requires further investigation.
Area of Science:
- Neurosurgery
- Endoscopic Surgery
- Pituitary Gland Tumors
Background:
- Endoscopic pituitary surgery is increasingly utilized.
- Limited data exists on its safety and advantages compared to microscope-based approaches.
- Existing reports often have small sample sizes and non-randomized designs.
Purpose of the Study:
- To evaluate the safety and short-term efficacy of endoscopic pituitary surgery.
- To provide a comprehensive analysis of outcomes through meta-analysis.
- To compare endoscopic techniques with traditional methods indirectly through pooled data.
Main Methods:
- Retrospective review of institutional data.
- Systematic literature review of published studies.
- Pooled data analysis for descriptive statistics on short-term outcomes.
Main Results:
- Pooled gross tumor removal rate was 78%.
- High rates of hormone resolution for specific pituitary tumors (ACTH, GH, Prolactin).
- Low complication rates: 2% for CSF leak, 1% for permanent diabetes insipidus, and 0.24% mortality.
Conclusions:
- Endoscopic pituitary surgery demonstrates safety and short-term efficacy.
- The procedure achieves significant tumor removal and hormone resolution.
- Further research with long-term follow-up is necessary to assess tumor control.
