Endoscopic versus Microscopic Trans-Sphenoidal Approach for Pituitary Adenomas: Retrospective Comparison Study in Single Institution

Background: the trans-sphenoidal approach has been proposed as a minimally invasive surgical technique for the removal of pituitary tumors. Objective: Is the endoscopic trans-sphenoidal surgery has superiority on the microscopic trans-sphenoidal surgery regarding the tumor resection and complications? Patients and Methods: We retrospectively collected 132 patients with pituitary adenomas treated by transsphenoidal surgery whether microscopic or endoscopic and comparing the morbidity, mortality and the extension of the tumor resection in both groups. Results: There were 73 females and 59 males with mean age 43.37±8.88 years. Fifty patients (37.9%) have been treated by the microscopic technique and eighty two patients (62.1%) have been treated by the endoscopic technique. Most of our cases were Macro adenoma without extra sellar extension. Vascular injury were detected in three cases in the endoscopic group and only one case in the microscopic group Mortality rate in the microscopic group is 6% which is higher than the endoscopic group which is 3.65%. Conclusion: Endoscopic trans-sphenoidal surgery achieves more extended tumor resection without significant difference in the complications rate.