[1]任光辉、沈嘉伟、李武雄.神经内镜与显微镜下经鼻蝶入路手术切除无功能性垂体腺瘤疗效和安全性的Meta分析[J].临床神经外科杂志,2019,16(04):402-405.[doi:10.13798/j.issn.1009-153X.2019.07.007]
 REN Guang-hui,SHEN Jia-wei,LI Wu-xiong..Curative effects of endoscopic and microscopic transsphenoidal surgeries on non-functioning pituitary adenomas and their safety: a Meta analysis[J].Journal of Clinical Neurosurgery,2019,16(04):402-405.[doi:10.13798/j.issn.1009-153X.2019.07.007]
点击复制

神经内镜与显微镜下经鼻蝶入路手术切除无功能性垂体腺瘤疗效和安全性的Meta分析()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年04期
页码:
402-405
栏目:
论著
出版日期:
2019-08-15

文章信息/Info

Title:
Curative effects of endoscopic and microscopic transsphenoidal surgeries on non-functioning pituitary adenomas and their safety: a Meta analysis
文章编号:
1009-153X(2019)07-0402-04
作者:
任光辉、沈嘉伟、李武雄
471003 河南洛阳,河南科技大学第三附属医院神经外科
Author(s):
REN Guang-hui SHEN Jia-wei LI Wu-xiong.
Department of Neurosurgery, The Third Affiliated Hospital, Henan University of Sciences and Technology, Luoyang 471003, China
关键词:
无功能性垂体腺瘤显微镜神经内镜经鼻蝶入路疗效Meta分析
Keywords:
Non-functioning pituitary adenomas Endoscopy Microscopy Trassphenoidal surgery Curative effects Safety
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2019.07.007
文献标志码:
A
摘要:
目的 系统评价神经内镜与显微镜下经鼻蝶入路手术切除无功能性垂体腺瘤的疗效和安全性。方法 计算机检索PubMed 、Embase、Cochrane Center、中国生物医学文献数据库、维普中文科技期刊全文数据库、万方数据库、中国知网等中英文数据库有关神经内镜、显微镜下经鼻蝶入路无功能性垂体腺瘤切除术的文献,时限为2018年7月之前。指标包括肿瘤切除率、脑脊液渗漏发生率和视力恢复率。结果 共纳入19篇文献,2 383例。Meta分析结果:神经内镜手术全切除率比显微镜手术要高(75% vs 62%,P<0.001),神经内镜组视力恢复率也高于显微镜组(82% vs 59%,P<0.001)。两组脑脊液漏发生率无统计学差异(4%vs 6%,P=0.078)。结论 与显微镜下手术相比,神经内镜手术切除无功能性垂体腺瘤的疗效更好。
Abstract:
Objective To evaluate the curative effects of endoscopic and microscopic transsphenoidal surgeries on non-functional pituitary adenomas (NFPA)and their safety. Methods The data bases including PubMed, Embase, Cochrane center, WanFang, VIP and CNKI were searched for the studies of curative effects of microscopic and endoscopic transsphenoidal surgeries on non-functioning pituitary adenomas and their safety published before July, 2018. Meta-analysis of their curative effects and safety was performed. Results Of 19 eligible studies involving 2383 patients derived from the above-mentioned data bases, 5 were double arm studies including 1 randomized controlled trial and 4 retrospective studies and 14 were single arm studies. The rates of gross tumor resection and postoperative visual improvement were significantly higher in the endoscopic group than those in microscopic group (P<0.001). There was insignificant difference in the rate of occurrence of cerebrospinal fluid leakage between both the groups (P=0.078). Conclusions The clinical effect of the endoscopic transsphenoidal surgery on NFPA is significantly better than that of the microscopic transsphenoidal surgery, but they are similar in the rate of occurrence of postoperative cerebrospinal leakage.

参考文献/References:

[1] Ezzat S, Asa SL, Couldwell WT, et al. The prevalence of pi- tuitary adenomas: a systematic review [J]. Cancer, 2004, 101 (3): 613-619. [2] Chen L, White WL, Spetzler RF, et al. A prospective study of nonfunctioning pituitary adenomas: presentation, mana- gement, and clinical outcome [J]. J Neurooncol, 2011, 102 (1): 129-138. [3] 吴世强,张 卓,周明辉,等. 神经导航及内镜辅助下经鼻 蝶显微切除无功能性垂体大腺瘤的近期疗效分析[J]. 中 国耳鼻咽喉颅底外科杂志,2016,22(4):284-287,292. [4] 韩 易,姜之全,郑夏林,等. 经鼻蝶入路切除垂体腺瘤两 种手术方式的疗效分析[J]. 中华医学杂志,2017,97 (19):1479-1483. [5] Messerer M, De Battista JC, Raverot G, et al. Evidence of improved surgical outcome following endoscopy for nonfun- ctioning pituitary adenoma removal [J]. Neurosurg Focus, 2011, 30(4): E11. [6] Dallapiazza R, Bond AE, Grober Y, et al. Retrospective ana- lysis of a concurrent series of microscopic versus endoscopic transsphenoidal surgeries for Knosp Grades 0-2 nonfunc- tioning pituitary macroadenomas at a single institution [J]. J Neurosurg, 2014, 121(3): 511-517. [7] Karppinen A, Kivipelto L, Vehkavaara S, et al. Transition from microscopic to endoscopic transsphenoidal surgery for nonfunctional pituitary adenomas [J]. World Neurosurg, 2015, 84(1): 48-57. [8] 惠国桢,王 清,吴智远,等. 老年无功能性垂体腺瘤的外 科治疗[J]. 中华神经外科杂志,2003,19(1):34-36. [9] 朱 瑞,丛雪枫,卞 威,等. 神经内镜下经鼻-蝶窦入路 无功能垂体腺瘤手术治疗[J]. 中华神经外科疾病研究杂 志,2013,12(1):62-64. [10] 王 清,鲁晓杰,汪 璟,等. 神经内镜经鼻蝶窦治疗老年 无功能性垂体腺瘤[J]. 中华神经外科杂志,2016,32(8): 785-788. [11] 贾 亮,张庆九,吕中强,等. 神经内镜下无功能垂体腺瘤 切除术后疗效分析[J]. 中国微侵袭神经外科杂志,2016, 21(5):212-213. [12] Alameda C, Lucas T, Pineda E, et al. Experience in mana- gement of 51 non-functioning pituitary adenomas: indica- tions for post-operative radiotherapy[J]. J Endocrinol Invest, 2005, 28(1): 18-22. [13] Berkmann S, Schlaffer S, Nimsky C, et al. Follow-up and long-term outcome of nonfunctioning pituitary adenoma operated by transsphenoidal surgery with intraoperative high-field magnetic resonance imaging [J]. Acta Neurochir (Wien), 2014, 156(12): 2233-2243. [14] Brochier S, Galland F, Kujas M, et al. Factors predicting relapse of nonfunctioning pituitary macroadenomas after neurosurgery: a study of 142 patients [J]. Eur J Endocrinol, 2010, 163(2): 193-200. [15] Dekkers OM, Pereira AM, Roelfsema F, et al. Observation alone after transsphenoidal surgery for nonfunctioning pi- tuitary macroadenoma [J]. J Clin Endocrinol Metab, 2006, 91(5): 1796-1801. [16] Magro E, Graillon T, Lassave J, et al. Complications related to the endoscopic endonasal transsphenoidal approach for nonfunctioning pituitary macroadenomas in 300 consecutive patients [J]. World Neurosurg, 2016, 89: 442-453. [17] Robenshtok E, Benbassat CA, Hirsch D, et al. Clinical course and outcome of nonfunctioning pituitary adenomas in the elderly compared with younger age groups [J]. Endocr Pract, 2014, 20(2): 159-164. [18] Tanemura E, Nagatani T, Aimi Y, et al. Quality of life in nonfunctioning pituitary macroadenoma patients before and after surgical treatment [J]. Acta Neurochir (Wien), 2012, 154(10): 1895-1902. [19] Yildirim AE, Sahinoglu M, Ekici I, et al. Nonfunctioning pituitary adenomas are really clinically nonfunctioning clinical and endocrinological symptoms and outcomes with endoscopic endonasal treatment [J]. World Neurosurg, 2016, 85: 185-192. [20] Zhan R, Ma Z, Wang D, et al. Pure endoscopic endonasal transsphenoidal approach for nonfunctioning pituitary ade- nomas in the elderly: surgical outcomes and complications in 158 patients [J]. World Neurosurg, 2015, 84: 1572-1578. [21] Li A, Liu W, Cao P, et al. Endoscopic versus microscopic transsphenoidal surgery in the treatment of pituitary adeno- ma: a systematic review and meta-analysis [J]. World Neurosurg, 2017, 101: 236-246.

相似文献/References:

[1]王勇,吴冲,张洪亮,等.神经内镜下切除功能性垂体瘤术后激素水平改善的效果分析[J].临床神经外科杂志,2015,(04):265.
[2]邢德广,陶钧,丁大领,等.无功能性垂体腺瘤87例临床治疗分析[J].临床神经外科杂志,2014,(04):262.
[3]王新栋,汤阳阳,刘厚强,等.神经内镜与显微镜下经鼻蝶垂体腺瘤切除的疗效比较[J].临床神经外科杂志,2018,15(04):292.
 WANG Xin-dong,TANG Yang-yang,LIU Hou-qiang,et al.Comparison of neuroendoscopic and transnasal-sphenoidal microscopic resection of pituitary adenoma[J].Journal of Clinical Neurosurgery,2018,15(04):292.

备注/Memo

备注/Memo:
(2018-09-28收稿,2019-03-08修回)
更新日期/Last Update: 1900-01-01