Evidence map›Paper›PMID 28913667›Full record

SynthesisActa neurochirurgica2017

Microsurgical versus endoscopic transsphenoidal resection for acromegaly: a systematic review of outcomes and complications.

Ching-Jen Chen, Natasha Ironside, I Jonathan Pomeraniec, Srinivas Chivukula, Thomas J Buell, Dale Ding, Davis G Taylor, Robert F Dallapiazza, Cheng-Chia Lee, Marvin Bergsneider

Abstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta neurochirurgica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Can acromegaly be controlled in all cases?Journal of neuroendocrinology · 2026
    Review
  6. Current treatment landscape of acromegaly.The Journal of clinical endocrinology and metabolism · 2026
    Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Role of Estrogen and Estrogen Receptor in GH-Secreting Adenomas.International journal of molecular sciences · 2023
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ching-Jen ChenDepartment of Neurological Surgery, University of Virginia Health System, PO Box 800212, Charlottesville, VA, 22908, USA. cc5hx@virginia.edu.
Natasha IronsideDepartment of Neurosurgery, Auckland City Hospital, Auckland, New Zealand.
I Jonathan PomeraniecDepartment of Neurological Surgery, University of Virginia Health System, PO Box 800212, Charlottesville, VA, 22908, USA.
Srinivas ChivukulaDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Thomas J BuellDepartment of Neurological Surgery, University of Virginia Health System, PO Box 800212, Charlottesville, VA, 22908, USA.
Dale DingDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Davis G TaylorDepartment of Neurological Surgery, University of Virginia Health System, PO Box 800212, Charlottesville, VA, 22908, USA.
Robert F DallapiazzaDepartment of Neurological Surgery, University of Virginia Health System, PO Box 800212, Charlottesville, VA, 22908, USA.
Cheng-Chia LeeDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Marvin BergsneiderDepartment of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.

Funding

UCLA Neurosurgery Research Training and Education ProgramR25NS079198 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI LIAU, LINDA M · 2012 to 2021
$1.2M
NINDS NIH HHS R25 NS079198
6 · The paper itself

Abstract

purposeThe aim of this systematic review is to evaluate the long-term endocrine outcomes and postoperative complications following endoscopic vs. microscopic transsphenoidal resection (TSR) for the treatment of acromegaly.

methodsA literature review was performed, and studies with at least five patients who underwent TSR for acromegaly, reporting biochemical remission criteria and long-term remission outcomes were included. Data extracted from each study included surgical technique, perioperative complications, biochemical remission criteria, and long-term remission outcomes.

resultsFifty-two case series from 1976 to 2016 met the inclusion criteria, comprising 4375 patients. Thirty-six reports were microsurgical (n = 3144) and 13 were endoscopic (n = 940). Three studies compared microsurgical (n = 111) to endoscopic TSR outcomes (n = 180). The overall initial and long-term remission rates were 58.2 vs. 57.4% and 69.2 vs. 70.2% for the microsurgical and endoscopic groups, respectively. For microadenomas, the initial and long-term remission rates were 77.6 vs. 82.2% and 76.9 vs. 73.5% for microsurgical and endoscopic approaches, respectively. For macroadenomas, the initial and long-term remission rates were 46.9 vs. 60.0% and 40.2 vs. 61.5% for microsurgical and endoscopic approaches, respectively. The rates of postoperative CSF leak were 3.0 vs. 2.3% for the microscopic and endoscopic groups, respectively. The rates of hypopituitarism and transient diabetes insipidus were 6.7 vs. 6.4% and 9.0 vs. 7.8% for the microscopic and endoscopic groups, respectively.

conclusionsBoth endoscopic and microsurgical approaches for TSR of growth hormone-secreting adenomas are viable treatment options for patients with acromegaly, and yield similarly high rates of remission under the most current consensus criteria.

Indexed as

AcromegalyCerebrospinal Fluid LeakEndoscopyGrowth Hormone-Secreting Pituitary AdenomaHumansHypopituitarismMicrosurgeryPituitary NeoplasmsPostoperative ComplicationsSphenoid BoneTreatment OutcomeAcromegalyEndoscopicGrowth hormoneMicroscopicPituitary adenomaReviewTranssphenoidal

Identifiers

PMID28913667
PMCPMC6558977

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.