UNASSIGNED: OBJECT The comparative efficacy of microscopic and fully endoscopic transsphenoidal surgery for @entity977 has not been well studied despite the adoption of fully endoscopic surgery by many pituitary centers. The influence of surgeon experience has also not been examined in this setting. The authors therefore compared the extent of @entity5 resection (EOR) and the endocrine outcomes of 1 very experienced surgeon performing a microscopic transsphenoidal surgery technique with those of a less experienced surgeon using a fully endoscopic transsphenoidal surgery technique for resection of nonfunctioning @entity977 in a concurrent series of @entity1 . METHODS Post hoc analysis was conducted of a cohort of adult @entity1 prospectively enrolled in a @entity977 quality-of-life study between October 2011 and June 2014. @entity1 were followed up for 6 months after surgery. @entity1 were treated either by a less experienced surgeon (100 independent cases) who practices fully endoscopic surgery exclusively or by a very experienced surgeon (1800 independent cases) who practices microscopic surgery exclusively. @entity1 demographic characteristics, @entity5 characteristics, @entity4614 , complications, and length of hospital stay were analyzed. @entity5 volumes and EOR were determined by formal volumetric analysis involving manual segmentation of MR images performed before surgery and within 6 months after surgery. Logistic regression analysis was used to determine predictors of EOR. RESULTS Fifty-five @entity1 underwent fully endoscopic transsphenoidal surgery, and 80 @entity1 underwent fully microscopic transsphenoidal surgery. The baseline characteristics of the 2 treatment groups were well matched. EOR was similar between the endoscopic and microscopic groups, respectively, as estimated by gross-total resection rate (78.2% vs 81.3%, p = 0.67), percentage of @entity5 resected (99.2% vs 98.7%, p = 0.42), and @entity41 (0.12 cm(3) vs 0.20 cm(3), p = 0.41). Multivariate modeling suggested that preoperative @entity5 volume was the most important predictor of EOR (p = 0.001). No difference was found in the development of @entity409 (p > 0.14), but there was a higher incidence of @entity409 in the microscopic group (p = 0.04). Combined rates of major complications and unplanned readmissions were lower in the endoscopic group (p = 0.02), but individual complications were not significantly different. CONCLUSIONS A less experienced surgeon using a fully endoscopic technique was able to achieve outcomes similar to those of a very experienced surgeon using a microscopic technique in a cohort of @entity1 with nonfunctioning @entity5 smaller than 60 cm(3). The study raises the provocative notion that certain advantages afforded by the fully endoscopic technique may impact the learning curve in pituitary surgery for nonfunctioning @entity652 .

Comparison of outcomes between a less experienced surgeon using a fully endoscopic technique and a very experienced surgeon using a microscopic transsphenoidal technique for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'Patient'] @entity41 :: ('MESH:D018365', 'Disease') :: ['volume of residual tumor'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumor', 'tumors'] @entity409 :: ('MESH:D008107', 'Disease') :: ['permanent posterior gland dysfunction', 'anterior gland dysfunction'] @entity4614 :: ('MESH:D007018', 'Disease') :: ['hypopituitarism'] @entity977 :: ('MESH:D010911', 'Disease') :: ['pituitary adenomas', 'pituitary adenoma'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenomas']
@entity977 :: (MESH:D010911,Disease) :: ['pituitary adenoma']
