AUTHOR=Chen Jia , Liu Hongyan , Man Siliang , Liu Geng , Li Quan , Zuo Qingyao , Huo Lili , Li Wei , Deng Wei 

TITLE=Endoscopic vs. Microscopic Transsphenoidal Surgery for the Treatment of Pituitary Adenoma: A Meta-Analysis

JOURNAL=Frontiers in Surgery

VOLUME=Volume 8 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.806855

DOI=10.3389/fsurg.2021.806855

ISSN=2296-875X

ABSTRACT=Purpose 
Currently, endoscopic and microscopic trans-sphenoidal surgery are commonly used surgical options for patients with pituitary adenomas. The purpose of this study is to evaluate the efficacy and safety of these two methods. 
Methods 
A computer search of Pubmed, Embase, Cochrane library, Web of Science and Google Scholar databases related to. The deadline is March 01, 2021. Through literature screening, data extraction and literature quality evaluation, the included literature was meta-analyzed using RevMan software 5.1. 
Results 
A total of 37 studies including 5591 patients were included. There was no significant difference in gross tumor removal (GTR) and hormone-excess secretion remission (HES remission) between two groups (RR=1.10, 95% CI:0.99-1.22, P=0.07; RR=1.09, 95% CI:1.00-1.20, P=0.05). Endoscopic trans-sphenoidal surgery was associated with lower incidence of diabetes insipidus (RR = 0.71, 95% CI: 0.58-0.87, P = 0.0008) hypothyroidism (RR = 0.64, 95% CI: 0.47-0.89, P = 0.007) and septal perforation (RR = 0.32, 95% CI: 0.13-0.79, P = 0.01) than those with microscopic trans-sphenoidal surgery. 
Conclusion 
This meta-analysis found that endoscopic trans-sphenoidal surgery cannot significantly improve GTR and HES remission, but it can reduce the incidence of diabetes insipidus, hypothyroidism and septal perforation without increasing the rate of other complications.