国内显微镜和神经内镜下经鼻蝶窦垂体腺瘤切除术后临床疗效的Meta分析

Clinical effectiveness of microscopic and neuroendoscopic endonasal transsphenoidal pituitary adenoma surgery in China： systematic review and Meta-analysis

目的 评价国内显微镜和神经内镜下经鼻蝶窦垂体腺瘤切除术后的临床疗效.方法 检索显微镜和神经内镜下经鼻蝶窦垂体腺瘤手术的病例对照研究文献,对符合条件的研究用revman 5.2软件录入数据及分析.结果 共纳入8篇病例对照试验文献,总计525例.肿瘤全切除率显微镜组较之神经内镜组,采用固定效应模型合并OR值为0.41（95％ CI：0.25～0.67）,P=0.0004;术后并发症显微镜组较之神经内镜组,采用固定效应模型进行加权合并OR值为1.90 （95％CI：1.24～2.91）,P=0.003,差异均具有统计学意义.结论 根据现有资料表明,神经内镜下经鼻蝶窦垂体腺瘤切除术式较显微镜在全切除率和减少术后并发症方面具有较好的优势.

Objective To evaluate the clinical effectiveness of microscopic and neuroendoscopic endonasal transsphenoidal pituitary adenoma resection in China.Methods The case-controlled trials of microscopic and neuroendoscopic endonasal transsphenoidal pituitary adenoma surgery were collected,and the systematic review and Meta-Analysis were conducted by revman 5.2 software.Results A total of 8 case-control trials involving 525 patients were included.As for the total resection rate and postoperative complications,significant differences were found between microscopic and neuroendoscopic endonasal transsphenoidal surgery （OR =0.41,95% CI：0.25-0.67,P =0.0004; OR =1.90,95% CI：1.24-2.91,P =0.003） respectively.Conclusions According to the available data,endoscopic transsphenoidal surgery provided favorable results in both tumour resection and control of complications in comparison with microscopic surgery.