Meta-analysis of endoscopic versus sublabial pituitary surgery. [Review]

MedStar author(s):
Citation: Laryngoscope. 122(3):511-8, 2012 Mar.PMID: 22252670Institution: MedStar Washington Hospital CenterDepartment: Neurosurgery | OtolaryngologyForm of publication: Journal ArticleMedline article type(s): Journal Article | Meta-Analysis | ReviewSubject headings: *Endoscopy/mt [Methods] | *Otorhinolaryngologic Surgical Procedures/mt [Methods] | *Pituitary Gland/su [Surgery] | *Pituitary Neoplasms/su [Surgery] | *Sphenoid Bone/su [Surgery] | HumansLocal holdings: Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1996 - 2003ISSN:
  • 0023-852X
Name of journal: The LaryngoscopeAbstract: CONCLUSIONS: The sublabial transsphenoidal approach has been the gold standard for pituitary surgery for many years. However, meta-analysis of the recent literature demonstrates superior outcomes and decreased postoperative complications with the endoscopic approach, potentially justifying a shift toward endoscopic pituitary surgery. Copyright 2011 The American Laryngological, Rhinological, and Otological Society, Inc.METHODS: A MEDLINE search was conducted identifying all relevant literature in the English language from 1998 through 2010. Studies explicitly identifying pure sublabial or completely endoscopic approaches were included. Meta-analysis comparing the two techniques was performed for multiple outcome measures utilizing a random effects approach.OBJECTIVES/HYPOTHESIS: To determine whether the endoscopic or sublabial transseptal transsphenoidal approach for pituitary surgery has superior outcomes or decreased complication rates.RESULTS: A total of 21 endoscopic studies (n = 2,335) and 17 sublabial studies (n = 2,565) met inclusion criteria. Analysis revealed significantly superior rates of gross tumor resection (79% vs. 65%, P < .0001), as well as lower rates of cerebral spinal fluid leak (5% vs. 7%, P < .01), septal perforation (0% vs. 5%), and postoperative epistaxis (1% vs. 4%, P < .0001) for the endoscopic approach compared to the sublabial approach. There was no difference between the two techniques in the incidence of meningitis, diabetes insipidus, or resolution of hormonal abnormality. Hospital stay (P = .01) was shorter for endoscopic surgery compared to sublabial surgery, and there was no significant difference in terms of length of operation.STUDY DESIGN: Retrospective meta-analysis of literature.All authors: Aulisi E, Chia SH, Deeb Z, DeKlotz TR, Lu W, Makambi KHDigital Object Identifier: Date added to catalog: 2013-09-17
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 22252670

Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1996 - 2003

CONCLUSIONS: The sublabial transsphenoidal approach has been the gold standard for pituitary surgery for many years. However, meta-analysis of the recent literature demonstrates superior outcomes and decreased postoperative complications with the endoscopic approach, potentially justifying a shift toward endoscopic pituitary surgery. Copyright 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

METHODS: A MEDLINE search was conducted identifying all relevant literature in the English language from 1998 through 2010. Studies explicitly identifying pure sublabial or completely endoscopic approaches were included. Meta-analysis comparing the two techniques was performed for multiple outcome measures utilizing a random effects approach.

OBJECTIVES/HYPOTHESIS: To determine whether the endoscopic or sublabial transseptal transsphenoidal approach for pituitary surgery has superior outcomes or decreased complication rates.

RESULTS: A total of 21 endoscopic studies (n = 2,335) and 17 sublabial studies (n = 2,565) met inclusion criteria. Analysis revealed significantly superior rates of gross tumor resection (79% vs. 65%, P < .0001), as well as lower rates of cerebral spinal fluid leak (5% vs. 7%, P < .01), septal perforation (0% vs. 5%), and postoperative epistaxis (1% vs. 4%, P < .0001) for the endoscopic approach compared to the sublabial approach. There was no difference between the two techniques in the incidence of meningitis, diabetes insipidus, or resolution of hormonal abnormality. Hospital stay (P = .01) was shorter for endoscopic surgery compared to sublabial surgery, and there was no significant difference in terms of length of operation.

STUDY DESIGN: Retrospective meta-analysis of literature.

English

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