PituitaryFully endoscopic transsphenoidal surgery for functioning pituitary adenomas: A retrospective comparison with traditional transsphenoidal microsurgery in the same institution
Introduction
Endoscopy is increasingly used in the transsphenoidal approach to pituitary tumors. Many publications on endonasal endoscopic surgery stress the less invasive nature of this technique but report similar endocrinologic results to those obtained by traditional transsphenoidal microscopic surgery [3], [6], [13], [16], [22], [24], [27]. However, some publications point to a better endocrinologic outcome for functioning adenomas when using endoscopy compared with the results reported in the literature using the traditional technique [10], [17].
We report our experience in 2 successive series of patients operated on for functioning pituitary adenomas using the 2 different techniques to assess whether the use of a fully endoscopic technique has altered the quality of tumor resection.
Section snippets
Materials and methods
In September 2001, we abandoned the classic microsurgical approach to the pituitary gland in favor of the endoscopic procedure. We compared the outcome of the first 60 consecutive cases of hormonally functioning adenomas we operated on using a fully endoscopic endonasal transsphenoidal procedure (group A) with the results obtained previously in the last 60 consecutive cases of functioning adenomas operated on using the traditional microsurgical transsphenoidal technique (group B).
To produce
Results
These 2 series of patients are comparable in terms of age, pathology, and sex distribution. The longer follow-up period in group B is explained by the succession in time of the 2 groups.
Discussion
The aim of our study was to establish whether fully endoscopic surgery could improve the quality of resection of functioning adenomas and to evaluate the complications.
It is generally accepted that using the traditional transsphenoidal approach, success rates are related to tumor size and that less good results are achieved with the more extensive macroadenomas [8], [21], [23]. The invasive nature of the tumor is another factor that adversely influences the results [9], [19].
The first studies
Conclusions
The use of the fully transsphenoidal endoscopic procedure to treat hormonally functioning pituitary adenomas improved our surgical results in terms of the correction of hypersecretion in a recent series of patients compared with our previous experience using the traditional microsurgical approach. This improvement is essentially related to the better results obtained for noninvasive macroadenomas, which became as good as those obtained for microadenomas. In our experience, using the endoscopic
Acknowledgments
The first author would like to thank Prof J Noterman, Prof JL Christiaens, and Prof HK Shahinian for their encouragement to practice pituitary surgery.
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