RESUMO
Objective To evaluate the efficacy objectively and systematically between endoscopic and microscopic surgery for transsphenoidal pituitary adenoma by a Meta-analysis.Methods A systematic literature search of Medline,the Cochrane Library,the Web of Science and the Google Scholar were performed to recruit studies between January,1990 and May,2015 that compared endoscopic and microscopic approaches in the treatment of pituitary adenomas.A Meta-analysis(R-3.1.3) was conducted to estimate the effect of different operative procedures.Results A total of 22 studies including 3 randomized or quasi-randomized controlled trails and 19 case-control studies met the inclusion criteria.Among 1421 patients studied,733 of them were treated with endoscopic and 688 were treated with microscopic surgery.The rate of gross tumor removal was higher in patients who underwent endoscopic surgery (71％) than those who underwent microscopic surgery (56％)(P ＜ 0.05).The rate of remission of hypersecretion was also higher in patients who underwent endoscopic surgery(60％) than those who underwent microscopic surgery(54％),but the difference was not significantly(P ＞ 0.05).Conclusion The present study indicates that the endoscopic transsphenoidal approach is more effective than microscopic surgery in the treatment of pituitary adenomas.