TY - JOUR
T1 - Microscopic versus endoscopic pituitary surgery
T2 - A systematic review
AU - Rotenberg, Brian
AU - Tam, Samantha
AU - Ryu, Won Hyung A.
AU - Duggal, Neil
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/7
Y1 - 2010/7
N2 - Objectives/Hypothesis: To critically review current literature comparing microscopic versus endoscopic surgery in the treatment of pituitary adenomas. Study Design: Systematic review of the literature. Methods: All English language literature published between January 1989 and June 2009 on PubMed were eligible for inclusion. Inclusion criteria were: direct comparison between microscopic and fully endoscopic approaches and surgery performed with the intent to treat a pituitary adenoma. Endoscopic-assisted comparisons and studies comparing outcomes with previous literature were excluded. Technical notes, case reports, letters, and comments were also excluded. Included studies were categorized according to level of evidence and evaluated for quality using a modified Downs and Black scale. Data was extracted and compared between studies. Results: Of the 3,586 studies retrieved from the search strategy, 11 studies met the inclusion and exclusion criteria. Various outcomes measures were used including: operating time, extent of tumor resection, postoperative normalization of hormone levels, incidence of complications, length of hospital stay, and patient pain and discomfort. The endoscopic approach decreased operating time, lumbar drains, immediate postoperative diabetes insipidus, some rhinologic complications, length of hospital stay, and patient pain and discomfort. Other outcome measures were comparable between the two approaches. Conclusions: The literature comparing endoscopic and microscopic pituitary surgery favors the endoscopic approach for pituitary surgery. Major outcome measures (extent of tumor resection, changes in hormone levels) do not differ between the two approaches. Complications, time in the operating room and hospital, and patient discomfort are significantly less with the endoscopic approach.
AB - Objectives/Hypothesis: To critically review current literature comparing microscopic versus endoscopic surgery in the treatment of pituitary adenomas. Study Design: Systematic review of the literature. Methods: All English language literature published between January 1989 and June 2009 on PubMed were eligible for inclusion. Inclusion criteria were: direct comparison between microscopic and fully endoscopic approaches and surgery performed with the intent to treat a pituitary adenoma. Endoscopic-assisted comparisons and studies comparing outcomes with previous literature were excluded. Technical notes, case reports, letters, and comments were also excluded. Included studies were categorized according to level of evidence and evaluated for quality using a modified Downs and Black scale. Data was extracted and compared between studies. Results: Of the 3,586 studies retrieved from the search strategy, 11 studies met the inclusion and exclusion criteria. Various outcomes measures were used including: operating time, extent of tumor resection, postoperative normalization of hormone levels, incidence of complications, length of hospital stay, and patient pain and discomfort. The endoscopic approach decreased operating time, lumbar drains, immediate postoperative diabetes insipidus, some rhinologic complications, length of hospital stay, and patient pain and discomfort. Other outcome measures were comparable between the two approaches. Conclusions: The literature comparing endoscopic and microscopic pituitary surgery favors the endoscopic approach for pituitary surgery. Major outcome measures (extent of tumor resection, changes in hormone levels) do not differ between the two approaches. Complications, time in the operating room and hospital, and patient discomfort are significantly less with the endoscopic approach.
KW - Endoscopic surgery
KW - Minimally invasive surgery
KW - Pituitary adenoma
UR - http://www.scopus.com/inward/record.url?scp=77954395192&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954395192&partnerID=8YFLogxK
U2 - 10.1002/lary.20949
DO - 10.1002/lary.20949
M3 - Review article
C2 - 20578228
AN - SCOPUS:77954395192
SN - 0023-852X
VL - 120
SP - 1292
EP - 1297
JO - Laryngoscope
JF - Laryngoscope
IS - 7
ER -