gms | German Medical Science

68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
7. Joint Meeting mit der Britischen Gesellschaft für Neurochirurgie (SBNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

14. - 17. Mai 2017, Magdeburg

Endoscopic vs. microscopic transsphenoidal tumor resection of pituitary adenomas: a systematic review and meta-analysis

Meeting Abstract

  • Feng Zheng - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Xintong Zhang - Department of Neurosurgery, The Second Clinical Medical School of Inner Mongolia University for the Nationalities (Inner Mongolia Forestry General Hospital), Inner Mongolia, Inner Mongolia, China
  • Christina A. Hamisch - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Marco Timmer - Allgemeine Neurochirurgie, Uniklinik Köln, Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Pantelis Stavrinou - Neurochirurgische Abteilung, Uniklinik Köln, Uniklinik Köln, Köln, Deutschland
  • Roland Goldbrunner - Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Boris Krischek - Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.23.02

doi: 10.3205/17dgnc308, urn:nbn:de:0183-17dgnc3080

Veröffentlicht: 9. Juni 2017

© 2017 Zheng et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The endonasal transsphenoidal approach to treat pituitary tumors is widely used. For the past 15 years, the endoscopic endonasal technique is used increasingly. However, there is no systematic review or meta-analysis comparing the rate of gross total tumor removal and complications between the microscopic and the endoscopic transsphenoidal technique.

Methods: In this paper, the authors report a systematic review and meta-analysis of gross tumor removal, mean operative time, postoperative complications such as the occurrence rate of cerebrospinal fluid leak, diabetes insipidus, hypopituitarism, epistaxis, comparing two techniques of pituitary adenoma resection. Randomized controlled trials and non-randomized cohort studies comparing the endonasal transsphenoidal microscopic technique to the endoscopic technique were considered for inclusion.

Results: Seven published reports of eligible studies involving 613 participants met the inclusion criteria. 277 patients were treated microsurgically and 336 endoscopically. Compared to the microscopic technique (M), the endoscopic technique (E) showed a significantly higher rate of gross tumor removal (63,8% versus 77,3%, P=0.004). However, there were no significant differences in mean operative time (M mean: 75.5min versus E mean: 64.5min, P=0.43), occurrence rate of cerebrospinal fluid leak (4.6% (M) vs. 4.8% (E), P=0.64), postoperative diabetes insipidus (4.8% (M) vs. 4.4% (E) (P=0.69), postoperative hypopituitarism (14.5% (M) vs. 9.6%(E) (P=0.2) or epistaxis (1.8% (M) vs. 0.6% (E), P=0.44).

Conclusion: Compared to the transsphenoidal microscopic technique, the endoscopic technique may have an advantage on achieving gross total tumor removal. Neither of the techniques seemed to have an advantage on the mean operative time, or the occurrence of postoperative complications.