Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2019; 7(13): 1591-1598
Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1591
Neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas
Zhi-Quan Ding, Sheng-Fan Zhang, Qing-Hua Wang
Zhi-Quan Ding, Sheng-Fan Zhang, Qing-Hua Wang, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangzhou 510282, Guangdong Province, China
Author contributions: Ding ZQ designed the research, collected the patients’ clinical data, and wrote the paper; Zhang SF collected the patients’ clinical data and contributed to writing the paper; Wang QH contributed to designing the research and writing the paper; All authors have read and approved the final version of this manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Zhujiang Hospital of Southern Medical University.
Informed consent statement: Patients were not required to give informed consent to participate in the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qing-Hua Wang, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, 253# Gongye Road, Guangzhou 510282, Guangdong Province, China. zjwqh@smu.edu.cn
Telephone: +86-20-61643268 Fax: +86-20-61643272
Received: January 21, 2019
Peer-review started: January 22, 2019
First decision: April 18, 2019
Revised: April 29, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: July 6, 2019
Processing time: 167 Days and 6.7 Hours
Abstract
BACKGROUND

Nonfunctional pituitary adenoma is a common type of pituitary adenoma, which can lead to headache, visual field disturbance, and cranial nerve damage due to increased tumor volume. Neuroendoscopic and microscopic transsphenoidal approaches have been widely used in the resection of nonfunctional pituitary adenomas. However, the clinical efficacy in neuroendoscopic and microscopic surgery is still controversial.

AIM

To explore the clinical efficacy of neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas.

METHODS

We retrospectively analyzed 251 patients with nonfunctional pituitary adenomas; 138 underwent neuroendoscopic surgery via transsphenoidal approach, and 113 underwent microscopic surgery via transsphenoidal approach between July 2010 and September 2015. All patients were followed up for > 6 mo. Gender, age, course of disease, tumor diameter, tumor location, and percentage of patients with headache, visual impairment, sexual dysfunction, and menstrual disorders were contrasted between the two groups to compare the difference of preoperative data. Cure rate, symptom improvement rate, recurrence rate, the postoperative hospital stay, operating time, intraoperative blood loss, and the incidence of postoperative complications were compared in order to evaluate the advantages and disadvantages of neuroendoscopic and microscopic surgery.

RESULTS

There was no significant difference in cure rate, symptom improvement rate, and recurrence rate between neuroendoscopy group and microscopy group (82.6% vs 85.8%, P > 0.05; 90.6% vs 93.8%, P > 0.05; 5.1% vs 9.7%, P > 0.05). In the neuroendoscopy group, the postoperative hospital stay was 8.4 ± 0.6 d; operating time was 167.2 ± 9.6 min; intraoperative blood loss was 83.4 ± 9.3 mL, and the rates of diabetes insipidus and electrolyte imbalance were 4.3% and 8.0%, respectively. The corresponding results in the microscopic group were 11.2 ± 0.6 d, 199.7 ± 9.3 min, 138.8 ± 13.6 mL, and 32.7% and 20.4%, respectively. There were significant differences in postoperative hospital stay, operating time, intraoperative blood loss, and the rates of diabetes insipidus and electrolyte imbalance between the two groups (P < 0.05).

CONCLUSION

Neuroendoscopic and microscopic transsphenoidal approaches have similar clinical efficacy for the resection of nonfunctional pituitary adenomas. Neuroendoscopic surgery reduces operating time, intraoperative bleeding, postoperative recovery, and complications.

Keywords: Nonfunctional pituitary adenomas; Neuroendoscopy; Microscopy; Transsphenoidal approach; Clinical efficacy

Core tip: Nonfunctional pituitary adenomas often require surgical treatment using a neuroendoscopic and microscopic transsphenoidal approach for resection. However, the clinical efficacy of neuroendoscopic and microscopic surgery may be different. The aim of this study was to explore the clinical efficacy of neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas. The clinical efficacy of neuroendoscopic and microscopic surgery was similar. Compared with microscopic surgery, neuroendoscopic surgery reduced operating time, intraoperative bleeding, postoperative recovery time, and complications.