PLA Rocket Force Characteristic Medical Center, Department of Neurosurgery - Beijing, China.
Rev Assoc Med Bras (1992). 2021 Nov;67(11):1687-1691. doi: 10.1590/1806-9282.20210732.
This study aims to compare the efficacy and safety of endoscopic transsphenoidal pituitary surgery and microscopic transseptal pituitary surgery in the treatment of Cushing's disease (CD).
A total of 46 patients with CD were randomized into endoscopic group and microscopic group, with 23 cases in each group. The endoscopic group received the endoscopic transsphenoidal pituitary surgery, and the microscopic group received the microscopic transseptal pituitary surgery. The retrospective data, surgical outcomes, surgical cure rates, and complications in two groups were compared.
Compared with microscopic group, the operative time was significantly shorter (p<0.05), the estimated blood loss was significantly less (p<0.05), and the hospital stay was significantly shorter (p<0.05) in endoscopic group. The surgical cure rate in endoscopic and microscopic groups was 69.56% and 60.86%, respectively, with no significant difference between the two groups (p>0.05). The incidence of complications in endoscopic group was significantly lower than that in microscopic group (p<0.01).
For the treatment of CD, the efficacy of endoscopic transsphenoidal pituitary surgery is basically the same as that of traditional microscopic transseptal pituitary surgery. However, the endoscopic surgery can further shorten the operative time, reduce the estimated blood loss, shorten the hospital stay, and reduce the complications.
本研究旨在比较内镜经鼻蝶窦垂体手术和显微镜经鼻中隔垂体手术治疗库欣病（CD）的疗效和安全性。
将 46 例 CD 患者随机分为内镜组和显微镜组，每组 23 例。内镜组行内镜经鼻蝶窦垂体手术，显微镜组行显微镜经鼻中隔垂体手术。比较两组患者的回顾性资料、手术结果、手术治愈率和并发症。
与显微镜组相比，内镜组的手术时间明显缩短（p<0.05），估计出血量明显减少（p<0.05），住院时间明显缩短（p<0.05）。内镜组和显微镜组的手术治愈率分别为 69.56%和 60.86%，两组间差异无统计学意义（p>0.05）。内镜组并发症发生率明显低于显微镜组（p<0.01）。
对于 CD 的治疗，内镜经鼻蝶窦垂体手术的疗效基本与传统显微镜经鼻中隔垂体手术相同。然而，内镜手术可以进一步缩短手术时间，减少估计出血量，缩短住院时间，减少并发症。
