Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques

Abstract Background Non-functioning pituitary adenomas have been treated by gross total resection with the microscopic transsphenoidal approach being the standard for decades. Recently, the endoscope has been utilized as alternative with its possible advantages and disadvantages. Methods In this stu...

Full description

Bibliographic Details
Main Authors: Hatem Adel Sabry, Ahmad Elsayed Desoukey Elayouty, Hazem Antar Mashaly, Alyaa Ahmed Elsherbeny, Aya Yassin
Format: Article
Language:English
Published: SpringerOpen 2018-10-01
Series:Egyptian Journal of Neurosurgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s41984-018-0019-2
_version_ 1831838585675841536
author Hatem Adel Sabry
Ahmad Elsayed Desoukey Elayouty
Hazem Antar Mashaly
Alyaa Ahmed Elsherbeny
Aya Yassin
author_facet Hatem Adel Sabry
Ahmad Elsayed Desoukey Elayouty
Hazem Antar Mashaly
Alyaa Ahmed Elsherbeny
Aya Yassin
author_sort Hatem Adel Sabry
collection DOAJ
description Abstract Background Non-functioning pituitary adenomas have been treated by gross total resection with the microscopic transsphenoidal approach being the standard for decades. Recently, the endoscope has been utilized as alternative with its possible advantages and disadvantages. Methods In this study, the authors retrospectively reviewed 58 cases who underwent transsphenoidal non-functioning pituitary adenomas resection, 25 via the microscopic approach (group 1) and 33 via the endoscopic approach (group 2). Different aspects of the procedures were compared, including duration of surgery, incidence of post-operative cerebrospinal fluid leak (being one of the common complications after such procedures), length of hospital stay postoperatively, and most importantly the tumor volume reduction being measured in a novel method by creating a computer-generated three-dimensional reconstruction of the tumor. Results The length of hospital stay for group 1 ranged from 2 to 9 days (mean 3.6 days, SD 2.141) while in group 2, it ranged from 2 to 7 days (mean 3.727 days, SD 1.008). Operative time mean was 92.7 min in group 1 and 142.79 min in group 2. Intraoperative CSF leak was encountered in 40% (n = 10) of the cases in group 1 and in five cases (15.2%) from group 2. Volume reduction percentage had a mean of 82.4% in group 1 and 89.1% in group 2. Although the mean of volume reduction percentage was higher in group 2, yet this difference was found to be statistically insignificant with a p value of 0.141. Conclusion Endoscopic approach showed superiority by having lower incidence of post-operative cerebrospinal fluid leak, length of hospital stay, and tumor volume reduction while the microscopic approach was only favored in having shorter mean duration of surgery.
first_indexed 2024-12-23T05:36:20Z
format Article
id doaj.art-5d32e1bfa6944e38bfa357e574c041bc
institution Directory Open Access Journal
issn 2520-8225
language English
last_indexed 2024-12-23T05:36:20Z
publishDate 2018-10-01
publisher SpringerOpen
record_format Article
series Egyptian Journal of Neurosurgery
spelling doaj.art-5d32e1bfa6944e38bfa357e574c041bc2022-12-21T17:58:20ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252018-10-013311610.1186/s41984-018-0019-2Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniquesHatem Adel Sabry0Ahmad Elsayed Desoukey Elayouty1Hazem Antar Mashaly2Alyaa Ahmed Elsherbeny3Aya Yassin4Faculty of Medicine, Ain Shams UniversityFaculty of Medicine, Ain Shams UniversityFaculty of Medicine, Ain Shams UniversityFaculty of Medicine, Ain Shams UniversityFaculty of Medicine, Ain Shams UniversityAbstract Background Non-functioning pituitary adenomas have been treated by gross total resection with the microscopic transsphenoidal approach being the standard for decades. Recently, the endoscope has been utilized as alternative with its possible advantages and disadvantages. Methods In this study, the authors retrospectively reviewed 58 cases who underwent transsphenoidal non-functioning pituitary adenomas resection, 25 via the microscopic approach (group 1) and 33 via the endoscopic approach (group 2). Different aspects of the procedures were compared, including duration of surgery, incidence of post-operative cerebrospinal fluid leak (being one of the common complications after such procedures), length of hospital stay postoperatively, and most importantly the tumor volume reduction being measured in a novel method by creating a computer-generated three-dimensional reconstruction of the tumor. Results The length of hospital stay for group 1 ranged from 2 to 9 days (mean 3.6 days, SD 2.141) while in group 2, it ranged from 2 to 7 days (mean 3.727 days, SD 1.008). Operative time mean was 92.7 min in group 1 and 142.79 min in group 2. Intraoperative CSF leak was encountered in 40% (n = 10) of the cases in group 1 and in five cases (15.2%) from group 2. Volume reduction percentage had a mean of 82.4% in group 1 and 89.1% in group 2. Although the mean of volume reduction percentage was higher in group 2, yet this difference was found to be statistically insignificant with a p value of 0.141. Conclusion Endoscopic approach showed superiority by having lower incidence of post-operative cerebrospinal fluid leak, length of hospital stay, and tumor volume reduction while the microscopic approach was only favored in having shorter mean duration of surgery.http://link.springer.com/article/10.1186/s41984-018-0019-2Non-functioning pituitary adenomasMicroscopic resectionEndoscopic resection
spellingShingle Hatem Adel Sabry
Ahmad Elsayed Desoukey Elayouty
Hazem Antar Mashaly
Alyaa Ahmed Elsherbeny
Aya Yassin
Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques
Egyptian Journal of Neurosurgery
Non-functioning pituitary adenomas
Microscopic resection
Endoscopic resection
title Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques
title_full Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques
title_fullStr Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques
title_full_unstemmed Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques
title_short Surgical outcome of non-functioning pituitary adenomas: a comparative study between microscopic and endoscopic techniques
title_sort surgical outcome of non functioning pituitary adenomas a comparative study between microscopic and endoscopic techniques
topic Non-functioning pituitary adenomas
Microscopic resection
Endoscopic resection
url http://link.springer.com/article/10.1186/s41984-018-0019-2
work_keys_str_mv AT hatemadelsabry surgicaloutcomeofnonfunctioningpituitaryadenomasacomparativestudybetweenmicroscopicandendoscopictechniques
AT ahmadelsayeddesoukeyelayouty surgicaloutcomeofnonfunctioningpituitaryadenomasacomparativestudybetweenmicroscopicandendoscopictechniques
AT hazemantarmashaly surgicaloutcomeofnonfunctioningpituitaryadenomasacomparativestudybetweenmicroscopicandendoscopictechniques
AT alyaaahmedelsherbeny surgicaloutcomeofnonfunctioningpituitaryadenomasacomparativestudybetweenmicroscopicandendoscopictechniques
AT ayayassin surgicaloutcomeofnonfunctioningpituitaryadenomasacomparativestudybetweenmicroscopicandendoscopictechniques