Comparison of Minimally Invasive Pituitary Surgery and Traditional Microscopic Hypophysectomy in the Treatment of Pituitary Tumors

Introduction: Surgical treatment of sellar and parasellar tumors by minimally invasive pituitary surgery (MIPS) is rapidly gaining popularity. The purpose of this study is to compare the perioperative and short-term outcomes of traditional microscopic trans-septal trans-sphenoidal hypophysectomy with the contemporary endoscopic minimally invasive technique. Methods: Twelve patients with pituitary macroadenomas underwent MIPS. Comprehensive analyses of patient records for demographics, operative times, hospital stays, and complications were performed. These data were compared to 12 randomly selected patients previously operated at the same institution using the microscopic trans-septal technique. A phone questionnaire was subsequently applied to assess postoperative sinonasal and cosmetic complications. Results: Operating times were significantly shorter in the MIPS group. Average hospital stay was also less in the MIPS group, although not statistically significant. Rates of complications, including CSF leak, meningitis, alar and septal tears, and bleeding were all higher in the microscopic group, as were patient-reported sinonasal and cosmetic problems. Conclusion: Compared with the traditional method of pituitary surgery, the minimally invasive endoscopic technique offers a number of advantages in addition to improved visualization. Patients spend less time in the operating room and hospital, and there appear to be significantly fewer immediate and short-term complications.