Comparison Of Endoscopic And Microscopic Trans-sphenoidal Pituitary Surgery

Purpose:Compare the trans-sphenoidal pituitary surgery efficacy under endoscope and microscope.Methods:Between 2008-2016,63 patients who underwent the microscopic trans-sphenoidal pituitary surgery were candidates for microscope group,85 patients who underwent the endoscopic trans-sphenoidal pituitary surgery were candidates for neuroendoscope group.The clinical data were collected from the above-mentioned two groups separately,especially in the age,gender,total-resection rate,duration of operation,recovery parameters and postoperative complications,which included the diabetes insipidus,leakage of cerebrospinal fluid,infection,the intracranial bleeding and the nasal bleeding.The t-test and χ2-test were performed as statistical analysis for measurement data and count data respectively.Results:The microscope group had 37 patients who underwent a total resection while 26 patients who underwent a partial resection.The neuroendoscope group had 66 patients who underwent a total resection while 19 patients underwent partial resection,the total-resection rate of neuroendoscope group is higher than microscope group(91.8%VS 76.2%),which had a statistical significance(χ2=6.935,p=0.008).Duration of operation for neuroendoscope group was shorter than that for microscope group(113.18±36.38min VS 134.37±57.31min),which had a statistical significance(t=2.575,p=0.012).Recovery parameters of neuroendoscope group was also shorter than microscope group(7.02±2.37days VS 8.00±2.78days),which had a statistical significance(t=2.293,p=0.023).Comparing the postoperative complications between two groups,the diabetes insipidus in microscope group was 3.2%,as well as 1.2%in neuroendoscope group(P=0.394).The leakage of cerebrospinal fluid in microscope group was 1.6%and in neuroendoscope group was 3.5%,which had no statistical significance(P=0.471).Infection in microscope group was 1.6%,while 1.2%patients developed an infectious disease in neuroendoscope group(P=0.831).Intracranial bleeding was 1.6%in microscope group and didn’t occurred in neuroendoscope group.Nasal bleeding in microscope group was 1.6%,as well as 9.4%in neuroendoscope group,and there was a statistical significance(χ2=3.879,p=0.049).Conclusion:Surgery under neuroendoscope increased the total-resection ratethe,shorted the duration of operation and the recovery parameters compared with that under microscope.And we can receive lower rate of diabetes insipidus,infection,the intracranial bleeding in after endoscopic trans-sphenoidal pituitary surgery.But the postoperative complications,which included leakage of cerebrospinal fluid and the nasal bleeding was higher under endoscopic surgery.In general,the efficacy of endoscopic trans-sphenoidal pituitary surgery was better than microscopic trans-sphenoidal pituitary surgery.