Comparative Study Of Transnasal-transsphenoidal Endoscopic Surgery And Microscopic Surgery Of Pituitary Tumor Resection

Pituitary tumor, also known as pituitary adenoma, which is caused by the abnormal proliferation of pituitary tissue cells, is one of the commonest clinical benign tumors, its incidence accounting for brain tumors is about 10%, and its pathogenesis is not clear at present.Surgery is the main treatment. Transsphenoidal endoscopic pituitary tumor surgery with its special advantages, developed in recent years is a new treatment of pituitary tumor.Objective:Our retrospective study was aimed to compare the role and complications of transnasal-transsphenoidal endoscopic surgery and microscopic surgery of pituitary tumor resection in order to evaluate the value of the former.Methods:Clinical data of pituitary tumor patients who had got the treatment in our hospital from January 2010 to January 2014. Patients included were divided into two groupsaccording to the treatment, endoscopic surgery group as the observer group(52 patients)and microscopic surgery group as the control group(48 groups). The general information,total tumor resection rate, recovery of vision, the cure rate of endocrine function, the incidence of surgical complications(epistaxis, sphenoid sinusitis, cerebrospinal fluid rhinorrhea, neurovascular injury, diabetes insipidus, pituitary dysfunction, intracranial infections, etc), the time of surgery and the length of hospital stay were compared between the two groups.Results:The difference of general information between the observer group and the control group was not statistically significant(p> 0.05). There was no statistically difference in the total tumor resection rate between the two groups(49/52 vs 44/48,Χ2=0.252,p=0.615); The same result was founded in the recovery of vision(25/27 vs 21/24,Χ2=0.373,p=0.542); In the observer group, 8 cases of somatotrophic adenoma were cured(72.7%,8/11), 7 cases of prolactinoma were cured(77.8%,7/9),4 cases of ACTH secreting adenoma were cured(80%,4/5), 3 cases of thyrostimuvating hormone secreting adenoma were cured(100%,3/3), the total cure rate was 78.6%(22/28); In the control group, 11 cases of somatotrophic adenoma were cured(78.6%,11/14), 6cases of prolactinoma were cured(75.0%,6/8),4 cases of ACTH secreting adenoma were cured(66.7%,4/6), 2 cases of thyrostimuvating hormone secreting adenoma were cured(66.7%,2/3), the total cure rate was 74.2%(23/31); the cure rate of endocrine function was no statistically difference(22/28 vs 23/31,Χ2=0.156,p=0.693). There was no statistical meaning of the incidence of complications in two groups(8/52 vs 10/48,Χ2=0.502, p>0.05). But the time of surgery and the length of hospital stay were statistically shorter in the observer groups than the control group(79±21 vs 93±26,t=2.972,p=0.004;5.6±2.4 vs 6.9±3.2,t=2.309,p=0.023).Conclusion:The role and complications of transnasal-transsphenoidal endoscopic surgery andmicroscopic surgery of pituitary tumor resection was similar, but the endoscopic surgery could shorten the time of surgery and the length of hospital stay. The endoscopic surgery was worth promoting.