Systematic review of efficacy and safety of the endoscopic versus the microscopic transsphenoidal surgery in the treatment of acromegaly

Abstract

Among the treatment options for Acromegaly, trans-sphenoidal surgery is the first option in most cases. Microscopic transsphenoidal surgery is a widely accepted and highly effective therapy for pituitary adenomas. However, over the past decade, several centers have converted to an endoscopic transsphenoidal approach; suggesting that this technique provides more complete tumor resection and reduces complications. Studies comparing these two techniques of surgery sometimes indicate advantages to endoscopic surgery and sometimes the results were similar. In addition, the principal existing studies took into account the old criteria for Acromegaly. This study will evaluate the efficacy and safety of endoscopic versus microscopic trans-sphenoidal surgery in the treatment of Acromegaly. If possible, the results will be compared regarding the old criteria for cure (basal GH <2,5 ng / mL and normal IGF1) versus the current (basal GH <1 ng/mL and normal IGF1). For this, there will be a systematic literature review according to Cochrane methodology. When the data from more than one study are homogeneous and with similar clinical outcomes, they will be plotted in a meta-analysis.(AU)