title: Microscopic versus endoscopic pituitary surgery.
abstract: OBJECTIVE
  The endoscopic techniques used in pituitary surgery have evolved greatly in recent years. Our objective in this study was to conduct a review of the systematic reviews published in the English language literature, to examine their consistency and conclusions reached following studies comparing microsurgery and endoscopic surgery in hypophyseal surgery.
  
  
  METHODS
  We carried out a bibliographic search on MEDLINE and EMBASE electronic databases, selecting those systematic reviews and meta-analyses published from the year 2000 until January 2013, focusing on comparisons between microsurgical and endoscopic techniques.
  
  
  RESULTS
  We concluded with type A consistency that hospital stay was shorter and diabetes insipidus and rhinological complications were less frequent in the endoscopy group. We concluded with type B consistency that lower rates of patient blood loss, shorter operative times, higher rate of gross total resection, lesser association to visual impairment and lower rate of hypopituitarism were observed in the endoscopy group. Vascular complications and cerebrospinal fluid fistulas were reduced with microsurgery. It is crucial to perform a combined analysis of all the systematic reviews treating a specific topic, observing and analysing the trends and how these are affected by new contributions.
  
  
  CONCLUSIONS
  Randomized multicenter studies are necessary to resolve the controversy over endoscopic and microsurgical approaches in hypophyseal pathology.
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain. Electronic address: juanantonio.simal@gmail.com.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Simal-Julián
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Miranda-Lloret
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pancucci
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Evangelista-Zamora
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Pérez-Borreda
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Sanromán-Álvarez
authors.affiliation: Servicio de Endocrinología, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Cámara-Gómez
authors.affiliation: Servicio de Neurocirugía, HUyP La Fe de Valencia, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Botella-Asunción
mesh_terms: D004724:Endoscopy; D006801:Humans; D008866:Microsurgery; D010902:Pituitary Gland / Q000601:surgery*
keywords: Adenoma hipofisario; Cirugía endoscópica; Cirugía microscópica; Endoscopic surgery; Microscopic surgery; Pituitary adenoma