{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:30:26Z","timestamp":1793179826030,"version":"4.5.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The value of endoscopic versus microsurgical approach has not yet been defined in transsphenoidal pituitary adenoma surgery. In this study, we compare both methods and analyze the long-term surgical, radiological, endocrinological, ophthalmological, and rhinological results as well as the patients\u2019 quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 33 individuals with elective transsphenoidal pituitary adenoma surgery were randomized (pure endoscopic approach or endoscope-assisted microscopic approach) and prospectively underwent investigations with a focus on patient-related subjective outcome measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean follow-up period was 6.3 years. In the microsurgical group, endoscopic inspection revealed residual tumor in seven of 15 patients (46.7%) not seen by the microscope. Endoscopic resection provided long-term tumor-free state in all of them. Compared to pure microsurgical treatment, endoscopy was associated with a lower probability of tumor recurrence (OR = 0.24) and appeared advantageous in the long-term achievement of any surgical goal (OR = 3.80) as well as in anterior pituitary lobe function improvement (OR = 1.60). Where gross total tumor resection was the stated preoperative goal, there was no long-term tumor recurrence in 81.8% (endoscopy group) and 83.3% (endoscope-assisted microsurgical group). Most aspects showed no significant difference between the techniques, such as length of hospital stay, complication rate (endoscopy: 16.7%, endoscope-assisted microsurgery: 20.0%), long-term maintenance of any preoperatively stated extent of resection, pituitary and olfactory function, rates of DI and SIADH, ophthalmological improvement, and SNOT scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both techniques provide good long-term surgical, radiological, endocrinological, rhinological, and ophthalmological results. Endoscopy clearly improved the rate of long-term achievement of the initial surgical goal and the anterior pituitary lobe function.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1552526","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T12:44:28Z","timestamp":1753188268000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of endoscopic and endoscope-assisted microscopic transsphenoidal surgery for pituitary adenoma resection: a prospective randomized study"],"prefix":"10.3389","volume":"16","author":[{"given":"M\u00e1rton","family":"E\u00f6rd\u00f6gh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"B\u00e1r\u00e1ny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Rosenstengel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Bogaczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Baldauf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Vogelgesang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Stahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kirsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Hosemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antje","family":"Steveling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Al Menabbawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry W. 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