Endoscopic transsphenoidal approach for clinically Non-Functioning Pituitary Neuroendocrine Tumor [Neurosurgery Wiki]

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====== Endoscopic transsphenoidal approach for clinically Non-Functioning Pituitary Neuroendocrine Tumor ======

[[Transsphenoidal approach for pituitary neuroendocrine tumor]] is well tolerated. Post-operative nasal symptoms transiently worsen but ultimately improve compared to pre-operative baseline. The operative approach (microscopic, endoscopic uninostril or endoscopic binostril) only has a transient effect on the severity of post-operative nasal symptoms
((Osborne C, Lewis D, Dixon B, Caputo C, Magee A, Gnanalingham K, Wang YY. Equivalent outcomes in nasal symptoms following microscopic or endoscopic transsphenoidal surgery: results from multi-centre, prospective study. Acta Neurochir (Wien). 2022 Jun;164(6):1589-1597. doi: 10.1007/s00701-022-05138-5. Epub 2022 Feb 8. PMID: 35133481; PMCID: PMC9160117.))
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The endoscopic approach may be associated with a higher rate of gross tumor movement and a lower risk of postoperative complications for treating nonfunctioning pituitary neuroendocrine tumor when compared with the microscopic approach. However, the confidence was shorted due to limited high-quality evidence (largely randomized and controlled studies)
((Yu SY, Du Q, Yao SY, Zhang KN, Wang J, Zhu Z, Jiang XB. Outcomes of endoscopic and microscopic transsphenoidal surgery on Non-Functioning Pituitary Neuroendocrine Tumors: a systematic review and meta-analysis. J Cell Mol Med. 2018 Mar;22(3):2023-2027. doi: 10.1111/jcmm.13445. Epub 2018 Jan 4. PMID: 29314715; PMCID: PMC5824383.)).
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Surgery can be safe and efficient during the learning period. Dedicated intensive learning, careful patient selection, and multidisciplinary work are key to shortening the learning curve and achieving satisfactory results
((Boetto J, Joitescu I, Raingeard I, Ng S, Le Corre M, Lonjon N, Crampette L, Favier V. Endoscopic transsphenoidal surgery for [[Non-Functioning Pituitary Neuroendocrine Tumor]]: Learning curve and surgical results in a prospective series during initial experience. Front Surg. 2022 Aug 2;9:959440. doi: 10.3389/fsurg.2022.959440. PMID: 35983556; PMCID: PMC9379140.)).