RT Journal Article
T1 Endoscopic Transnasal Trans-Sphenoidal Approach for Pituitary Adenomas: A Comparison to the Microscopic Approach Cohort by Propensity Score Analysis
A1 Castaño León, Ana
A1 Paredes Sansinenea, Igor
A1 Munarriz, Pablo
A1 Jiménez Roldán, Luis
A1 Hilario Barrio, Amaya
A1 Calatayud Gutiérrez, María
A1 Hernández Laín, Aurelio
A1 García, Ester
A1 García Fernández, Alfredo
A1 Lagares Gómez-Abascal, Alfonso
A1 Fernández Alén, José Antonio
AB BACKGROUND: Despite some evidence for the adoption of endoscopic transnasal trans-sphenoidal surgery (ETSS) for pituitary adenomas, the advantages of this technique over the traditional approach have not been robustly confirmed. OBJECTIVE: To compare ETSS with the microscopic sublabial trans-septal trans-sphenoidal surgery (MTSS) for pituitary adenomas. METHODS: We retrospectively reviewed 2 cohorts of ETSS and MTSS performed at our institution from 1995 to 2017. Patient characteristics, surgical data, and outcomes were recorded prospectively. We performed a univariate and multivariable analysis to determine the best surgical approach. To improve the quality of the results, we matched the distribution of patient characteristics between groups by propensity score (PS) method. RESULTS: A total of 187 procedures (90 MTSS, 97 ETSS) were reviewed. We found better results in the ETSS group in terms of gross total resection (P =. 002) and hormone-excess secretion control (P =. 014). There was also a lower incidence of cerebrospinal fluid leakage (P =. 039), transitory diabetes insipidus (P =. 028), and postoperative hypopituitarism (P =. 045), as well as a shorter hospital length of stay (P <. 001). After PS matching, we confirmed by multivariable logistic regression analysis an increased odds ratio of gross total resection for the ETSS (3.910; 95% CI 1.720-8.889; P =. 001). CONCLUSION: By PS method, our results suggest that the ETSS provides advantages over the traditional MTSS approach for tumor resection. Better control of secreting tumors and a lower rate of most complications also support the selection of the ETSS approach for the treatment of pituitary adenomas.
PB Wolters Kluwer Health Inc.
SN 0148-396X
YR 2020
FD 2020-03-01
LK https://hdl.handle.net/20.500.14352/116261
UL https://hdl.handle.net/20.500.14352/116261
LA eng
NO Castaño-Leon, Ana M MD; Paredes, Igor MD, PhD; Munarriz, Pablo M MD; Jiménez-Roldán, Luis MD, PhD; Hilario, Amaya MD, PhD; Calatayud, Maria MD; Hernandez-Lain, Aurelio MD, PhD; Garcia, Ester MD; Garcia, Alfredo MD; Lagares, Alfonso MD, PhD; Alén, Jose F MD, PhD. Endoscopic Transnasal Trans-Sphenoidal Approach for Pituitary Adenomas: A Comparison to the Microscopic Approach Cohort by Propensity Score Analysis. Neurosurgery 86(3):p 348-356, March 2020. | DOI: 10.1093/neuros/nyz201
DS Docta Complutense
RD 9 abr 2025