Neuroendoscopic transsphenoial surgery versus microscopic transsphenoial surgery for patients with pituitary adenomas
Objective To investigate the efficacies of neuroendoscopic transsphenoial surgery versus microscopic transsphenoial surgery for patients with pituitary adenomas and the effects on the levels of serum adrenocorticotropic hormone(ACTH),prolactin(PRL),and growth hormone(GH).Methods Eighty patients with pituitary adenomas diagnosed and treated in Shanxian Central Hospital from May 2015 to May 2023 were selected for the randomized controlled trial,and were divided into a study group and a control group by the random number table method,with 40 cases in each group.There were 23 males and 17 females in the study group;they were(50.29±5.25)years old.There were 20 males and 20 females in the control group;they were(51.09± 5.21)years old.The study group took neuroendoscopic transsphenoial approach resection,while the control group microscopic transsphenoial approach resection.The operation times,intraoperative bleeding volumes,hospitalization times,tumor resection rates,levels of ACTH,PRL,and GH,and incidences of complications were compared between the two groups.Independent sample t and x2 tests were applied.Results The operation time,hospitalization time,and intraoperative bleeding volume in the study group were less than those in the control group[(81.67±12.03)min vs.(114.35± 11.68)min,(7.51±1.18)d vs.(11.07±1.24)d,and(72.59±8.14)ml vs.(85.26±8.31)ml],with statistical differences(t=12.327,13.154,and 6.889;all P＜0.01).The complete resection rate in the study group was higher than that in the control group[87.50％(36/40)vs.70.00％(28/40);x2=3.660;P=0.056].Seven days after the operation,the serum levels of ACTH,PRL,and GH in the study group were lower than those in the control group[(15.37±4.19)pmol/L vs.(20.01±4.38)pmol/L,(1.33±0.48)nmol/L vs.(1.71±0.52)nmol/L,and(0.88±0.31)nmol/L vs.(1.09±0.37)nmol/L],with statistical differences(t=4.841,3.396,and 2.752;all P＜0.05).The incidence of complications in the study group was lower than that in the control group[10.00％(4/40)vs.27.50％(11/40)],with a statistical difference(x2=4.021;P=0.045).Conclusion The neuroendoscopic approach for pituitary adenoma resection is more conducive to promoting the patients'recovery of postoperative hormone levels and reducing the incidence of complications compared to the microscopic approach.
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