Hipofiz Adenomlarında Endoskopik ve Mikroskopik Transsfenoidal Cerrahi Arasındaki Postoperatif Sonuçların Karşılaştırmalı Analizi

Öz

Amaç: Bu çalışmada, hipofiz adenomları için endoskopik ve mikroskopik transsfenoidal cerrahi uygulanan hastaların postoperatif sonuçlarının karşılaştırılması amaçlanmıştır. Yöntemler: 2009-2013 yılları arasında Ankara Atatürk Eğitim ve Araştırma Hastanesi'nde tedavi edilen 71 hastanın retrospektif kohortu analiz edildi. Kırk hastaya endoskopik cerrahi, 31 hastaya ise mikroskopik cerrahi uygulandı. Ameliyat öncesi ve sonrası değerlendirmeler hormonal değerlendirmeler, görme fonksiyonu, radyolojik bulgular ve cerrahi komplikasyonları içeriyordu. Sonuçlar: Endoskopik grupta brüt total rezeksiyon %82 oranında, mikroskopik grupta ise %74 oranında sağlandı. Görme iyileşmesi endoskopik grupta daha belirgindi. BOS sızıntı oranları düşük ve benzerdi. Hormonal remisyon oranları gruplar arasında benzerdi. Hastanede kalış süresi endoskopik grupta daha kısaydı. Sonuç: Her iki teknik de güvenli ve etkilidir, ancak endoskopik yaklaşım daha iyi görüntüleme sağlayabilir, daha yüksek rezeksiyon oranlarına olanak tanıyabilir ve daha hızlı iyileşmeye yol açabilir.

Anahtar Kelimeler

• Hipofiz Adenomu
• Transsfenoidal Cerrahi
• Endoskopik Yaklaşım
• Mikroskobik Cerrahi

Comparative Analysis of Postoperative Outcomes Between Endoscopic and Microscopic Transsphenoidal Surgery for Pituitary Adenomas

Öz

Aim: This study aims to compare postoperative outcomes between patients undergoing endoscopic versus microscopic transsphenoidal surgery for pituitary adenomas. Material and Methods: A retrospective cohort of 71 patients treated at Ankara Atatürk Training and Research Hospital between 2009 and 2013 was analyzed. Forty patients underwent endoscopic surgery, and 31 patients underwent microscopic surgery. Pre- and postoperative assessments included hormonal evaluations, visual function, radiological findings, and surgical complications. Results: Gross total resection was achieved in 82% of the endoscopic group compared to 74% in the microscopic group. Visual improvement was more prominent in the endoscopic group. CSF leak rates were low and comparable. Hormonal remission rates were similar between groups. Hospitalization duration was shorter in the endoscopic group. Conclusion: Both techniques are safe and effective, but the endoscopic approach may provide better visualization, facilitate higher resection rates, and lead to faster recovery.

Anahtar Kelimeler

• Pituitary Adenoma
• Transsphenoidal Surgery
• Endoscopic Approach
• Microscopic Surgery

Kaynakça

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