Comparative Analysis Of Complications And Recurrence Of Invasive Pituitary Adenomas Excised By Neuroendoscope And Microscope Transnasal Approach

Objective: To compare the postoperative complications and recurrence of endoscopic resection of invasive pituitary adenoma under Neuroendoscope and microscope,so as to provide a clinical reference for surgical treatment of invasive pituitary adenoma.Methods: 76 cases of invasive pituitary adenoma treated in our hospital from December 2015 to March 2017 were studied.According to the random number table,all the patients were randomly divided into the neuroendoscopy group and the microscope group,38 cases in each group.The basic data of two groups of patients were collected.The neuroendoscopy group received transsphenoidal surgery by neuroendoscopy for invasive pituitary adenoma,and the microscope group received transsphenoidal surgery by microscope for invasive pituitary adenoma.The remission rate of clinical symptoms,the recovery of abnormal hormone level,the incidence of complications and the recurrence rate after operation were statistically analyzed in the two groups.Results: There was no significant difference in age,sex,educational level,occupation,course of disease,clinical manifestation and type of tumor in the two groups(P>0.05).There were some patients of the two groups had obvious clinical symptoms.After the operation,the clinical symptoms of the two groups were relieved in varying degrees,and the clinical symptom remission rate of the microscope group was 77.27%.The remission rate of the clinical symptoms in the neuroendoscopy group was 76.19%,and there was no significant difference between the two groups(P>0.05).Some of the two groups of patients had abnormal hormone levels.After operation,the hormone levels of the two groups were alleviated to varying degrees.The recovery rate of the abnormal hormone level in the microscope group was 79.17%.The rate of recovery of abnormal hormone levels in the neuroendoscopy group was 80.77%,and there was no significant difference between the two groups(P>0.05).Postoperative complications occurred in 3 patients in the endoscopy group.There were 9 postoperative complications in the microscope group,and the incidence of postoperative complications in the endoscopic group(7.89%)was significantly lower than that in the microscope group(23.68%).The difference between the two groups was statistically significant(P<0.05).All the complications were cured after the corresponding treatment.During the follow-up period of 1 years,there were 3 recurrent cases in the endoscopy group.There were recurrent cases in the 10 microscope group,and the recurrence rate in the endoscopic group(7.89%)was significantly lower than that in the microscope group(26.32%).The difference between the two groups was statistically significant(P<0.05).Conclusion: Neuroendoscopy resection of invasive pituitary adenomas is safe and effective.It can reduce the incidence of complications and reduce the recurrence of tumors.It has a significant advantage in the treatment of invasive pituitary adenomas,and can be further applied.