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Updated: Mar 13, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic Versus Microscopic Transsphenoidal Surgery for Pituitary Tumors
Huang Guo-Dong1, Ji Tao, Yang Ji-Hu
1*Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen University First Affiliated Hospital†The Central Laboratory, Shenzhen Key Laboratory of Neurosurgery, Shenzhen‡Department of Neurosurgery, Zhongshan City People's Hospital, Zhongshan, China.
Endoscopic endonasal transsphenoidal surgery (ETS) and microscopic transsphenoidal surgery (MTS) for pituitary tumors showed similar outcomes. ETS had longer operation times and more blood loss but may offer higher gross total resection rates for specific tumor grades.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Pituitary tumors require surgical intervention.
- Endoscopic endonasal transsphenoidal surgery (ETS) and microscopic transsphenoidal surgery (MTS) are common surgical approaches.
- Comparing clinical outcomes and complications is crucial for patient management.
Purpose of the Study:
- To compare the clinical outcomes and complications of endoscopic endonasal transsphenoidal surgery (ETS) versus microscopic transsphenoidal surgery (MTS) for pituitary tumor management.
- To evaluate the efficacy of each surgical approach based on tumor characteristics and patient recovery.
Main Methods:
- Retrospective review of 247 pituitary tumor patients (100 ETS, 147 MTS) from January 2007 to July 2014.
- Tumor stratification using Knosp and modified Hardy classifications.
- Comparison of gross total resection (GTR)/remission rates, visual improvement, complications, operative time, blood loss, and hospital stay.
Main Results:
- No significant differences in GTR rate, visual outcome, or complication rate between ETS and MTS.
- ETS demonstrated a higher GTR rate for Knosp grade III tumors compared to MTS.
- ETS was associated with longer operative time, greater intraoperative blood loss, and shorter hospital stay than MTS.
Conclusions:
- Both ETS and MTS are effective for pituitary tumor resection with comparable overall outcomes.
- ETS may offer an advantage in achieving GTR for higher-grade tumors (Knosp grade III).
- Surgeons should consider operative time, blood loss, and hospital stay when selecting the surgical approach.
