Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis

Acta neurochirurgica
Reem D AlmutairiHasan A Zaidi

Abstract

Microscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforded by eTSS may allow for higher rates of gross total tumor resection (GTR). The aim of this meta-analysis was to determine the rate of GTR using mTSS and eTSS. A meta-analysis of the literature was conducted using PubMed, EMBASE, and Cochrane databases through July 2017 in accordance with PRISMA guidelines. Seventy case series that reported GTR rate in 8257 pituitary adenoma patients were identified. For all pituitary adenomas, eTSS (GTR=74.0%; I2 = 92.1%) was associated with higher GTR as compared to mTSS (GTR=66.4%; I2 = 84.0%) in a fixed-effect model (P-interaction < 0.01). For functioning pituitary adenomas (FPAs) (n = 1170 patients), there was no significant difference in GTR rate between eTSS (GTR=75.8%; I2 = 63.9%) and mTSS (GTR=75.5%; I2 = 79.0%); (P-interaction = 0.92). For nonfunctioning pituitary adenomas (NFPAs) (n = 2655 patients), eTSS (GTR=71.0%; I2 = 86.4%) was associated with higher GTR as compared to mTSS (G...Continue Reading

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Citations

Mar 4, 2020·Acta neurochirurgica·Yujiro HattoriAkio Morita
Jul 12, 2020·The Journal of Clinical Endocrinology and Metabolism·Zihao WangBing Xing
Jul 12, 2020·Acta neurochirurgica·Helen C U OtaAngelos Kolias
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Jan 18, 2021·Medicina clínica·Carlos Pérez-LópezAlberto Isla Guerrero
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Jun 2, 2020·Neurosurgical Focus·Michal HlaváčAndrej Paľa

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