title: Comparison of endoscopic and microscopic trans-sphenoidal pituitary surgery: early results in a single centre.
abstract: BACKGROUND
  Pituitary surgery has seen a recent shift from a microscopic to an endoscopic trans-sphenoidal approach. We present our early experience with endoscopic surgery and compare the outcome with our recent microscopic experience.
  
  
  METHODS
  From January 2008 until present time, 80 consecutive patients underwent trans-sphenoidal pituitary surgery in our institution. Until September 2009, all patients had a microscopic trans-septal approach. After this time, the patients underwent endoscopic trans-sphenoidal surgery. All patients underwent pre- and post-operative MRI and full endocrinological evaluation. Data was collected prospectively including tumour volume, endocrine function, visual function, length of stay and complications.
  
  
  RESULTS
  There were 40 patients in each group. In the microscopic group, there were 26 non-functioning tumours and 14 functioning tumours. In the endoscopic group, there were 24 non-functioning and 16 functioning tumours. There were significantly better results in terms of tumour resection (p = 0.002) and remission (p = 0.018) in the endoscopic group. In this group there was also a lower incidence of CSF leaks and a shorter length of stay for secreting tumours (p = 0.005). 1 patient in the endoscopic group died at day 43 post-operatively, having initially presented in a poor clinical state with pituitary apoplexy.
  
  
  CONCLUSIONS
  Microscopic trans-sphenoidal surgery remains the benchmark for future surgical techniques. Our early results suggest that endoscopic trans-sphenoidal surgery provides favourable results in both tumour resection and control of secreting tumours in comparison with microscopic surgery. Further longer-term evaluation is required to ensure the outcome of endoscopic surgery.
authors: Department of Neurosurgery, Sheffield Teaching Hospitals and Sheffield Children's Hospital NHS Foundation Trusts, Sheffield, UK. adam.razak@doctors.org.uk
authors: Adam A
authors: AA
authors: Razak
authors: Michelle
authors: M
authors: Horridge
authors: Daniel J
authors: DJ
authors: Connolly
authors: Daniel J
authors: DJ
authors: Warren
authors: Showkat
authors: S
authors: Mirza
authors: Vakkat
authors: V
authors: Muraleedharan
authors: Saurabh
authors: S
authors: Sinha
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology; D044583:Neuroendoscopy / Q000379:methods*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D013100:Sphenoid Bone / Q000601:surgery; D047368:Tumor Burden; D055815:Young Adult