Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2019; 7(13): 1591-1598
Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1591
Neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas
Zhi-Quan Ding, Sheng-Fan Zhang, Qing-Hua Wang
Zhi-Quan Ding, Sheng-Fan Zhang, Qing-Hua Wang, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangzhou 510282, Guangdong Province, China
Author contributions: Ding ZQ designed the research, collected the patients’ clinical data, and wrote the paper; Zhang SF collected the patients’ clinical data and contributed to writing the paper; Wang QH contributed to designing the research and writing the paper; All authors have read and approved the final version of this manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Zhujiang Hospital of Southern Medical University.
Informed consent statement: Patients were not required to give informed consent to participate in the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qing-Hua Wang, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, 253# Gongye Road, Guangzhou 510282, Guangdong Province, China. zjwqh@smu.edu.cn
Telephone: +86-20-61643268 Fax: +86-20-61643272
Received: January 21, 2019
Peer-review started: January 22, 2019
First decision: April 18, 2019
Revised: April 29, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: July 6, 2019
ARTICLE HIGHLIGHTS
Research background

Nonfunctional pituitary adenoma is a common type of pituitary adenomas, which can lead to headache, visual field disturbance, and cranial nerve damage due to increased tumor volume. Neuroendoscopic and microscopic transsphenoidal approaches have been widely used in the resection of nonfunctional pituitary adenomas. However, the clinical efficacy in neuroendoscopic and microscopic surgery is still controversial.

Research motivation

The purpose of this study was to collect the clinical data of patients with nonfunctional pituitary adenomas treated by neuroendoscopic surgery via transsphenoidal approach or microscopic surgery via transsphenoidal approach at our hospital from 2010 to 2015. The clinical data was compared to explore the clinical efficacy of neuroendoscopic surgery and microscopic surgery, and to provide a direction for the choice of surgical methods for nonfunctional pituitary adeno-mas.

Research objectives

The main objective of this study was to explore the clinical efficacy of neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas.

Research methods

From 2010 to 2015, the clinical data of patients with nonfunctional pituitary adenomas treated by neuroendoscopic surgery via transsphenoidal approach or microscopic surgery via trans-sphenoidal approach were analyzed. All patients were followed up for > 6 mo. In this study, the t test and chi-square test were used to test the statistical differences between groups, which clearly confirmed the differences between the two groups.

Research results

In the neuroendoscopy group, the cure rate was 82.6%; symptom improvement rate was 90.6%; recurrence rate was 5.1%; the postoperative hospital stay was 8.4 ± 0.6 d; operating time was 167.2 ± 9.6 min; intraoperative blood loss was 83.4 ± 9.3 mL, and the rates of diabetes insipidus and electrolyte imbalance were 4.3% and 8.0%, respectively. The corresponding results in the microscopic group were 85.8%, 93.8%, 9.7%, 11.2 ± 0.6 d, 199.7 ± 9.3 min, 138.8 ± 13.6 mL, and 32.7% and 20.4%, respectively. We found that neuroendoscopic surgery reduces operating time, intraoperative bleeding, postope-rative recovery, and complications. This study will provide a direction for the choice of treatment methods for patients with nonfunctional pituitary adenomas in clinical work.

Research conclusions

The clinical efficacy of neuroendoscopic and microscopic transsphenoidal approach for the resection of nonfunctional pituitary adenomas was similar. However, compared to microscopic surgery, neuroendoscopic surgery reduced operating time, intraoperative bleeding, postope-rative recovery, and complications. This study will provide a direction for the choice of treatment methods for patients with nonfunctional pituitary adenomas in clinical work.

Research perspectives

This study was a retrospective single-center study, and the sample size was limited. In the future, a multicenter prospective study of nonfunctional pituitary adenomas could be attempted to further explore the long-term safety and efficacy of neuroendoscopic treatment for nonfun-ctional pituitary adenomas.