Endoscopic versus microscopic trans-sphenoidal pituitary surgery: a systematic review and meta-analysis.

摘要: Clin. Otolaryngol. 2011, 36, 212–220 Background:  Endoscopic trans-sphenoidal surgery has been increasingly replacing microscopic as the state of art approach. Objective review:  To assess efficacy and safety pure endoscopic approach in comparison with pituitary surgery. Type Literature review meta-analysis. Search strategy:  Systematic literature searches MEDLINE (1952–10th February 2010), EMBASE (1974–10th 2010) Cochrane Central Register Controlled Trials to 10th 2010. Evaluation method:  Review all English-language studies comparing techniques. Results:  Eleven relevant were identified a total 806 patients, 369 whom had 437 surgery. The initial remission rate hypersecretion functioning adenomas was not significantly different between group [(OR: 1.34(95% CI: 0.73–2.47); P = 0.35; 66% versus 60% microscopic)].The proportion patients complete tumour removal than 0.83, (95% 0.52–1.33); P = 0.44]. CSF leak attributable surgical method did differ group. Post-operative diabetes insipidus less frequent those having [15%versus 28%P = 0.003]. Regarding other intra cranial nasal complications technique, occurrence significant lower compared (13%versus 1.2% respectively, P < 0.05). Patients shorter postoperative hospital stay range from 3.7 4.4 days, 5.4 5.7 days [(WMD: −1.53, −2.30 −0.77); P < 0.00001)]. Conclusions:  Notwithstanding its limitations, present systematic review, based on currently available evidence, suggests that is associated similar rates excision rates. fewer related technique stay.