Sukyte-Raube Donata, Locatelli Davide, Castelnuovo Paolo, Alali Mustafa Haseeb, Lesinskas Eugenijus
Center of Ear, Nose and Throat Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania.
Department of Biotechnology and Life Sciences, Division of Neurosurgery, University of Insubria, Ospedale Di Circolo E Fondazione Macchi, Varese, Italy.
Eur Arch Otorhinolaryngol. 2025 Jun 11. doi: 10.1007/s00405-025-09516-4.
This study aimed to evaluate the effectiveness of the Endoscopic Diving Technique (EDT) as an adjunct to endoscopic endonasal transsphenoidal surgery in improving remission rates in patients with functional pituitary adenomas. The primary research question was whether EDT enhances early endocrinological and radiological remission without increasing surgical complications.
A prospective randomized trial was conducted at Vilnius University Hospital Santaros Klinikos between 2021 and 2023, with 141 patients diagnosed with functional pituitary adenomas. Seventy-eight patients met inclusion criteria and were randomly assigned to either the EDT group (n = 43), which included an additional endoscopic hydroscopy step, or the non-EDT group (n = 35). Follow-up assessments were performed at 3, 12, and 24 months to evaluate endocrinological and radiological remission. Additional parameters analyzed included surgical complications, operative duration, and water volume used for EDT.
The EDT group demonstrated significantly higher early endocrine remission rates (83.7% vs. 60.0%, p = 0.023) and fewer radiological relapses at 3 months (86.0% vs. 68.6%, p = 0.097), 12 months (81.4% vs. 62.9%, p = 0.078), and 24 months (69.8% vs. 42.9%, p = 0.022). Surgical complication rates were comparable between the groups (4.7% vs. 2.9%, p = 1.000).
The implementation of EDT as an adjunct to transsphenoidal surgery is associated with improved endocrinological and radiological remission rates in functional pituitary adenomas without increasing surgical risk. EDT enhances visualization of the sellar cavity, facilitates tumor removal, and reduces venous hemorrhage, making it a valuable addition to standard surgical practice.
本研究旨在评估内镜潜水技术（EDT）作为鼻内镜经蝶窦手术辅助手段对提高功能性垂体腺瘤患者缓解率的有效性。主要研究问题是EDT能否在不增加手术并发症的情况下提高早期内分泌和影像学缓解率。
2021年至2023年在维尔纽斯大学医院圣塔罗斯临床医院进行了一项前瞻性随机试验，141例患者被诊断为功能性垂体腺瘤。78例患者符合纳入标准，被随机分为EDT组（n = 43），该组包括额外的内镜水检查步骤，以及非EDT组（n = 35）。在3个月、12个月和24个月进行随访评估，以评估内分泌和影像学缓解情况。分析的其他参数包括手术并发症、手术持续时间和EDT使用的水量。
EDT组在3个月时早期内分泌缓解率显著更高（83.7%对60.0%，p = 0.023），且在3个月（86.0%对68.6%，p = 0.097）、12个月（81.4%对62.9%，p = 0.078）和24个月（69.8%对42.9%，p = 0.022）时影像学复发较少。两组手术并发症发生率相当（4.7%对2.9%，p = 1.000）。
将EDT作为经蝶窦手术的辅助手段与功能性垂体腺瘤内分泌和影像学缓解率提高相关，且不增加手术风险。EDT增强了蝶鞍腔的可视化，便于肿瘤切除并减少静脉出血，使其成为标准手术操作中有价值的补充。
