[The safety and efficacy of endoscopic versus microscopic surgery for transsphenoidal pituitary adenoma in China: an updated and cumulative meta-analysis]

Abstract

Objective: To evaluate the present clinical effectiveness and its change trend by an updated and cumulative meta-analysis of endoscopic versus microscopic surgery for transsphenoidal pituitary adenoma in China.

Methods: We conducted a systematic review of the literature related to theme,and the meta-analysis of the data extracted onto a standard form was conducted by State 12.0 software.

Results: Finally 14 studies were included. There were 1 888 patients in total including 962 patients receiving endoscopic surgery and 926 patients undergoing microscopic surgery. Compared with microscopic group,there were significant advantages in endoscopic group including the high rate of complete tumor resection (OR=1.951, 95% CI: 1.525-2.495) and the lower incidence of overall operation complication (OR=0.480, 95% CI: 0.298-0.773) and cerebrospinal fluid leakage (OR=0.592, 95% CI: 0.399-0.878), but the advantage of the incidence rate of diabetes insipidus (OR=0.72, 95% CI: 0.420-1.252) was no statistically significant. Cumulative meta-analysis suggested that the advantage of total resection of tumor has stabilized in 2013.

Conclusion: At present in our country, compared with microscopic group, there were significant advantages in endoscopic group including the rate of complete tumor resection and the incidence of overall operation complications and cerebrospinal fluid leakage, but the advantage of the incidence rate of diabetes insipidus was no statistically significant difference. The follow-up studies related to the rate of total resection of tumor may not change the existing meta-analysis results.