Prognostic Factors Of Endoscopic Endonasal Transsphenoidal Surgery For Acromegaly:A Meta-analysis

Objective This study aims to identify the relevant factors affecting the prognosis of patients with acromegaly after endoscopic transsphenoidal butterfly surgery by meta-analysis of studies published in China and abroad,and to provide an evidence-based basis for the treatment of patients with acromegaly,in the hope of improving their quality of life.Methods The databases of China Biomedical Literature Database(CBM),China Knowledge Network(CNKI),Wanfang Database,Wipu Database,The Cochrane Library,Pub Med,Embase,etc.were searched,and the search terms were "butterfly bone","acromegaly",or "growth hormone-secreting pituitary adenoma","prognosis" or"treatment The relevant literature was searched for the subject terms "pterygoid","acromegaly" or "pituitary adenoma secreting growth hormone","prognosis" or"treatment outcome" and their free words.Review Manager 5.4.1 software was used to statistically analyze the extracted data.Results Twenty-three papers met the inclusion criteria,and the results of the Meta-analysis showed that the factors associated with the prognosis of patients with acromegaly treated with endoscopic transsphenoidal butterfly were: preoperative growth hormone level(OR = 1.03,95% CI:1.02-1.04,P<0.00001),postoperative growth hormone level(OR = 2.42,95% CI:0.78-7.47,P< 0.00001),whether the cavernous sinus was invaded(OR=3.86,95% CI:3.52-4.23,P<0.00001),Knosp classification(OR=7.15,95% CI:5.54-9.23,P<0.00001),and tumor size(OR=1.61,95% CI:1.49-1.74,P<0.00001).Conclusion The results of this Meta-analysis found that patients with lower preoperative and postoperative growth hormone levels,no invasion of the cavernous sinus,low Knosp classification,and smaller tumors(microadenomas)were more likely to have a good prognosis after endoscopic surgery.