Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection
Background: Endoscopic pituitary surgery might yield better endocrine outcomes compared to microscopic resection. We conducted a prospective, randomized, single-blinded study to compare the endocrine outcome and quality of life (QoL) of patients with newly diagnosed pituitary adenoma who underwent e...
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2025-01-01
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| author | Andrej Pala Nadja Grübel Benjamin Mayer Ralf Becker Fabian Sommer Bernd Schmitz Gwendolin Etzrodt-Walter Christian Rainer Wirtz Michal Hlavac |
| author_facet | Andrej Pala Nadja Grübel Benjamin Mayer Ralf Becker Fabian Sommer Bernd Schmitz Gwendolin Etzrodt-Walter Christian Rainer Wirtz Michal Hlavac |
| author_sort | Andrej Pala |
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| description | Background: Endoscopic pituitary surgery might yield better endocrine outcomes compared to microscopic resection. We conducted a prospective, randomized, single-blinded study to compare the endocrine outcome and quality of life (QoL) of patients with newly diagnosed pituitary adenoma who underwent either endoscopic or microscopic transsphenoidal surgery (NCT03515603). Methods: Due to slow recruitment, this study had to be stopped prematurely. Out of 170 transsphenoidal pituitary surgeries performed during the study period, 36 patients were enrolled in this study. The primary endpoint was based on the development of a new hypopituitarism. Secondary endpoints included the extent of resection, complications, and QoL. Results: Endoscopic surgery was performed in 47.2% (n = 17). A new hypopituitarism was found in 8.3% (n = 3). All these cases underwent microscopic resection. Arginine vasopressin deficiency was found in 2.7% (n = 1) after microscopic resection. Gross total resection was achieved in 94.4% (n = 34). No surgical complications or new neurological deficits were observed. QoL improved significantly after the surgery, as measured by EQ-VAS (<i>p</i> = 0.003). According to EQ-5D3L, QoL improved or remained unchanged in almost all patients. No significant difference was found in QoL between the endoscopic and microscopic groups. Conclusion: The endoscopic technique appears to offer benefits in the treatment of pituitary adenomas, particularly in terms of achieving a favorable endocrine outcome. |
| format | Article |
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| institution | Kabale University |
| issn | 2035-8377 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Neurology International |
| spelling | doaj-art-bcd918d95feb478b84281e11fdef24e12025-01-24T13:44:23ZengMDPI AGNeurology International2035-83772025-01-01171510.3390/neurolint17010005Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic ResectionAndrej Pala0Nadja Grübel1Benjamin Mayer2Ralf Becker3Fabian Sommer4Bernd Schmitz5Gwendolin Etzrodt-Walter6Christian Rainer Wirtz7Michal Hlavac8Department of Neurosurgery, University of Ulm, Lindenallee 2, 89312 Günzburg, GermanyDepartment of Neurosurgery, University of Ulm, Lindenallee 2, 89312 Günzburg, GermanyInstitute of Epidemiology and Medical Biometry, University of Ulm, Schwabstr. 13, 89075 Ulm, GermanyDepartment of Neurosurgery, University of Ulm, Lindenallee 2, 89312 Günzburg, GermanyDepartment of Otolaryngology-Head and Neck Surgery, University of Ulm, Frauensteige 12, 89075 Ulm, GermanyDepartment of Neuroradiology, University of Ulm, Lindenallee 2, 89312 Günzburg, GermanyEndokrinologiezentrum Ulm, Weinbergweg 41, 89075 Ulm, GermanyDepartment of Neurosurgery, University of Ulm, Lindenallee 2, 89312 Günzburg, GermanyDepartment of Neurosurgery, University of Ulm, Lindenallee 2, 89312 Günzburg, GermanyBackground: Endoscopic pituitary surgery might yield better endocrine outcomes compared to microscopic resection. We conducted a prospective, randomized, single-blinded study to compare the endocrine outcome and quality of life (QoL) of patients with newly diagnosed pituitary adenoma who underwent either endoscopic or microscopic transsphenoidal surgery (NCT03515603). Methods: Due to slow recruitment, this study had to be stopped prematurely. Out of 170 transsphenoidal pituitary surgeries performed during the study period, 36 patients were enrolled in this study. The primary endpoint was based on the development of a new hypopituitarism. Secondary endpoints included the extent of resection, complications, and QoL. Results: Endoscopic surgery was performed in 47.2% (n = 17). A new hypopituitarism was found in 8.3% (n = 3). All these cases underwent microscopic resection. Arginine vasopressin deficiency was found in 2.7% (n = 1) after microscopic resection. Gross total resection was achieved in 94.4% (n = 34). No surgical complications or new neurological deficits were observed. QoL improved significantly after the surgery, as measured by EQ-VAS (<i>p</i> = 0.003). According to EQ-5D3L, QoL improved or remained unchanged in almost all patients. No significant difference was found in QoL between the endoscopic and microscopic groups. Conclusion: The endoscopic technique appears to offer benefits in the treatment of pituitary adenomas, particularly in terms of achieving a favorable endocrine outcome.https://www.mdpi.com/2035-8377/17/1/5transsphenoidal pituitary surgeryhypopituitarismarginine vasopressin deficiencyendoscopic techniquemicroscopic technique |
| spellingShingle | Andrej Pala Nadja Grübel Benjamin Mayer Ralf Becker Fabian Sommer Bernd Schmitz Gwendolin Etzrodt-Walter Christian Rainer Wirtz Michal Hlavac Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection Neurology International transsphenoidal pituitary surgery hypopituitarism arginine vasopressin deficiency endoscopic technique microscopic technique |
| title | Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection |
| title_full | Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection |
| title_fullStr | Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection |
| title_full_unstemmed | Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection |
| title_short | Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection |
| title_sort | endocrine outcome and quality of life after transsphenoidal resection of pituitary adenoma a prospective randomized single blinded study comparing endoscopic versus microscopic resection |
| topic | transsphenoidal pituitary surgery hypopituitarism arginine vasopressin deficiency endoscopic technique microscopic technique |
| url | https://www.mdpi.com/2035-8377/17/1/5 |
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