134   Comparison of Extent of Tumor Resection and Endocrine Outcomes for Nonfunctioning XXXX of a Less Experienced Surgeon Using a Fully Endoscopic Transsphenoidal Surgery Technique to a Very Experienced Surgeon Using a Microscopic Transsphenoidal Surgical Technique.

@entity1 @entity41 @entity5 @entity409 @entity977
INTRODUCTION: The comparative efficacy of microscopic and fully endoscopic transsphenoidal surgery for @entity977 has not been well studied despite the adoption of fully endoscopic surgery by many pituitary centers. We compared the extent of @entity5 resection (EOR) and the endocrine outcomes of 1 very experienced surgeon performing a microscopic-transsphenoidal surgery technique (1800 independent cases) with those of a less experienced surgeon using a fully endoscopic-transsphenoidal surgery technique (100 independent cases) for nonfunctioning @entity977 in a concurrent series of @entity1 . METHODS: Post hoc analysis was conducted of a cohort of adult @entity1 prospectively enrolled in a @entity977 quality-of-life study between 2011 and 2014. RESULTS: Fifty-five @entity1 underwent fully endoscopic transsphenoidal surgery, and 80 @entity1 underwent fully microscopic transsphenoidal surgery. Baseline characteristics of the 2 treatment groups were well matched. EOR was similar between the endoscopic and microscopic groups, respectively, as estimated by gross total resection rate (78.2% vs 81.3%, P = .67), percentage of @entity5 resected (99.2% vs 98.7%, P = .42), and @entity41 (0.12 cm vs 0.20 cm, P = .41). Multivariate modeling suggested that preoperative @entity5 volume was the most important predictor of EOR (P = .001). No difference was found in the development of @entity409 (P > .14), but there was a higher incidence of @entity409 in the microscopic group (P = .04). Combined rates of major complications and unplanned readmissions were lower in the endoscopic group (P = .007), but individual complications were not different. CONCLUSION: A less experienced surgeon using a fully endoscopic technique was able to achieve similar outcomes compared with a very experienced surgeon using a microscopic technique in a cohort of @entity1 with nonfunctioning @entity5 . These data suggest that certain advantages afforded by the fully endoscopic technique help address the learning curve in pituitary surgery.
