Comparison of the Therapeutic Effects of Endoscopic Transnasal Submucosal Approach and Tradi-tional Transnasal Transsphenoidal Approach for Pituitary Adenoma Resection
[Objective]To compare the clinical outcomes of endoscopic transnasal submucosal approach and traditional transnasal transsphenoidal approach for pituitary adenoma resection.[Methods]A retrospective analysis was conducted on the clinical data of 85 patients with pituitary adenomas admitted to our hospital from March 2019 to April 2024.According to the surgical approach plan,they were divided into a nasal septum submucosal group(transnasal septum submucosal ap-proach,n=45)and a nasal butterfly group(transnasal butterfly approach,n=40).The incidence of postoperative compli-cations,olfactory function,nasal ventilation function,and hormone levels before and after surgery were compared between the two groups.[Results]There was no statistically significant difference in the total effective rate between the two groups of patients(P＞0.05).The intraoperative tumor resection rate and cerebrospinal fluid leakage rate in the submucosal group of the nasal septum were not significantly different from those in the nasal butterfly group(P＞0.05);The opera-tion time and bleeding volume of the submucosal group of the nasal septum were lower than those of the nasal butterfly group,and the difference was statistically significant(P＜0.05).Compared with preoperative values,the olfactory recog-nition thresholds of the two groups were higher at 1 month,3 months,and 6 months after surgery,and the nasal septum submucosal group was lower than the nasal butterfly group,with statistical significance(P＜0.05).At 3 and 6 months af-ter surgery,the nasal inspiratory and expiratory resistance in both groups were higher than before surgery,and the submu-cosal group of the nasal septum was lower than the nasal butterfly group,with a statistically significant difference(P＜0.05).Six months after surgery,the levels of serum prolactin,growth hormone,and adrenocorticotropic hormone in both groups were lower than before surgery(P＜0.05),but there was no significant difference in these indicators between the two groups at six months after surgery(P＞0.05).The total incidence of postoperative complications in the submucosal group of the nasal septum was lower than that in the nasal butterfly group,and the difference was statistically significant(P＜0.05).[Conclusion]Neuroendoscopic transnasal submucosal approach for pituitary adenoma resection has minimal damage to the patient's olfactory function,low incidence of postoperative complications,and high clinical significance.
万方数据
维普
