Table 1.
Study characteristics
| Author (year) | Study design | Main in- and exclusion criteria | Sample size endoscopic patients | Age in years mean (SD)/median (range) | Number female (%) | Tumor subtypes | Tumor size | Gross total resection |
|---|---|---|---|---|---|---|---|---|
| Studies reporting both visual acuity and visual field deficit | ||||||||
| Bokhari (2013) | Retrospective case series | Inclusion: PA, fully endoscopic transsphenoidal surgery (1998–2010) | 79 | Mean age: 56.7 (SD: 16.3) | 44 (56%) | NF 39 (49%), PRL 16 (20%), GH 19 (24%), ACTH 4 (5), TSH 1 (1) | NS | 50 (63%) |
| Campbell (2010) | Retrospective case series | Inclusion: GH producing adenomas (2005–2009) | 26 | Mean age: 45.7 (–) | 12 (46%) | GH (100%) | 84.6% ≥10 mm: 84.6% | 26 (73%) |
| Chabot (2015) | Retrospective case series | Inclusion: adenoma size >3 cm (2009–2014) | 39 | Median age: 56.3 (SD: 15.6) | 14 (40%) | NS | >4 cm: 15.6% | NS |
| Juraschka (2014) | Retrospective case series | Inclusion: PA patients (2006–2012) maximum tumor diameter in any plane ≥3 cm, and tumor volume ≥10 cm3. Exclusion: lack of suprasellar growth | 73 | Mean: 55 (SD: 15) | 23 (32%) | NF 65 (89%) functioning 6 (8.2%), unknown: 2 (2.8%) | Mean: 4.09 cm | 73 (24%) |
| Karppinen (2015) | Retrospective case series | Inclusion: NFPA patients (2000–2011) endoscopic and transnasal. Exclusion: craniectomy, re-resection, hormonally active adenomas and pituitary carcinoma | 41/185 | 58.5 (SD: 16) | 18 (44%) | NF 185 (100%) | Mean: 27 (SD: 9) | 23 (41%) |
| Yildrim (2016) | Retrospective case series | Inclusion: NFPA pure endoscopic endonasal transsphenoidal technique (2009–2014) | 160 | Mean age 49 (–) | 72 (45%) | NF: 160 (100%) | Mean: 2.48 cm (–) | 160 (90%) |
| Studies only reporting visual acuity | ||||||||
| Constantino (2016) | Retrospective case series | Inclusion: PAs with diameter >3 cm (2010–2014) | 28 | Mean age: 46 (–) | 11 (40%) | NS | Mean: 4.6 cm (–) | 28 (14%) |
| De Witte (2011) | Retrospective case series | Inclusion: PA resected endoscopic transsphenoidal (2007–2010) | 83 | Mean age: 50 (–) | 39 (47%) | NF 40 (48.3%), PRL 6 (7.2%), GH 6 (7.2%), ACTH 3 (3.6%), TSH 1 (1.2%), mixed 17 (20.5%) | 73 Macroadenomas | 83 (30%) |
| Fan (2014) | Retrospective case series | Inclusion: PA resections (2005–2010) | 28 | Median age: 43 (–) | 17 (60%) | NF 17 (60.1), PRL 5 (17.9%), GH 3 (10.7%), ACTH 2 (7.2%) mixed: 1 (3.6%) | 25 >1 cm | 28 (57%) |
| Studies only reporting visual field deficit | ||||||||
| Anik (2011) | Retrospective case series | Inclusion: PA with visual field deficits. Exclusion: comorbidity that can influence vision (2009–2010) | 72 | Mean age: 45.7 (SD: 10.9) | 43 (57%) | NF 42 (58.3), PRL 6 (8.3%), GH 22 (30.5%), ACTH 2 (2.8%) | NS | NS |
| Akin (2016) | Retrospective case series | Inclusion: prolactinomas reected endonasally (2006–2012) | 142 | Mean age: 35.5 (SD: 13.3) | 76 (54%) | PRL 142 (100%) | 113 Macroadenomas, 10 giant adenomas | NS |
| Cappabianca (1999) | Retrospective case series | Inclusion: pituitary adenoma, microscopic (1996) endoscopic (1997) | 10/30 | Range: 33–67 | 4 (40%) | NF 5 (50%), GH 5 (50%) | 7 Microadenomas | 9 (90%) |
| Chi (2013) | Retrospective case series | Inclusion: PA with endonasal extension (2011–2012) | 80 | Mean age: 51 (–) | 35 (44%) | NF 24 (30%), PRL 26 (32.5%), GH 9 (11.3%), ACTH 3 (3.8%), TSH 3 (3.8%), mixed 5 (6.3%) | 16 Microadenomas | 80 (64%) |
| Cho (2002) | Retrospective case series | Inclusion: cohort of endoscopic and sublabial resection of prolactinomas (1996–2000) | 22/44 | Mean age: 45 (–) | 22 (100%) | PRL 22 (100%) | NS | NS |
| Dallapiazza (2015) | Retrospective case series | Inclusion: NFPA patients with >5 year follow-up | 80 | Mean age: 57 (SD: 13) | 42 (53%) | NF 80 (100%) | 31 > 3.0 cm | 80 (71%) |
| Dehdashti (2008) | Retrospective case series | Inclusion: PA patients, purely endoscopic endonasal operation (2004–2007). Exlcusion: very large pituitary adenomas and extended approaches | 200 | Mean age 50 (–) | 109 (55%) | NF 111 (55.5%), PRL 25 (12.5%), GH 34 (17%), ACTH 27 (13.5), TSH 3 (1.5) | NS | 182 (97%) |
| D’Haens (2009) | Retrospective case series | Inclusion: pituitary adenoma resected microscopic (1995–2001), endoscopic (2001–2007) | 60/120 | Mean age 37 (–) | 41 (68%) | PRL 29 (48%), GH 13 (23%), ACTH 16 (27%), TSH 2 (3%) | NS | NS |
| Leach (2010) | Retrospective case series | Inclusion: sellar lesions (2005–2007) operated endoscopically | 89/125 | NS | NS | NF 67 (54%), PRL 9 (7%), GH 22 (18%), ACTH 10 (8%), craniopharyngioma 4 (3%), Other 7 (6%) | NS | NS |
| Minet (2008) | Retrospective case series | Inclusion: PA with >6 month follow-up (2003–2005) | 31/71 | Mean age: 51.4 (17.2) (endonasal) | 14 (45%) (endonasal) | NF 27 (87%) PRL 2 (7%), TSH: 1 3 (%), GH: 1 (3%) | NS | NS |
| Nakao (2011) | Retrospective case series | Inclusion: giant NFPA endonasal resection (2000–2008) | 43 | Mean age: 55 (–) | 20 (47%) | NF 43 | Mean diameter: 47.8 mm (SD 1.2) | 20 (47%) |
| Paluzzi (2014) | Retrospective case series | Inclusion: purely endoscopic operated PA patients (2002–2011) | 555 | NS | NF 360 (69.2), PRL 53 (10%), GH 49 (10%), ACTH 58 (11%) | 89.4% >1 cm | 359 (65%) | |
| Sheehan (1999) | Retrospective case series | Inclusion: NFPA endonasal resection (1995–1997) | 26/70 | Mean age: 59.2 (SD: 15.1) | 8 (31%) | NS | Volume: 11.0 (SD: 6.9) cm3 | NS |
| Studies reporting unspecified visual function | ||||||||
| Chohan (2016) | Retrospective case series | Inclusion: PAs with size >10 cm3 or cross sectional length >4 cm (2003–2014) | 62 | Mean age 54 (–) | 27 (44%) | NS | Median volume: 13.74 cm3 | 62 (47%) |
| Cusimano (2012) | Retrospective case series | Inclusion: giant pituitary adenomas (>10 cm3) resected endoscopically or by craniotomy or microscopically (1994–2001) | 29/72 | Mean age 50 (SD: 15) | 13 (45%) | NF 25 (83%), functioning 4 (17%) | Mean: 4.0 cm | 26 (91%) |
| Gondim (2014) | Retrospective case series | Inclusion: giant pituitary adenomas >4 cm (1998–2011) | 50 | Mean age: 48.2 (–) | 17 (34%) | NF 42 (80%) GH 5 (10%) PRL 3 (6%) | >4 cm | 50 (38%) |
| Gondim (2015) | Retrospective case series | Inclusion: NFPA exclusion: previous surgery, age >70 (2000–2012) | 55 | Mean age: 72.5 (SD: 2) | 23 (42%) | NF 55 (100%) | Mean size 33 mm (SD: 23) | 55 (78%) |
| Ferreli (2014) | Retrospective case series | Inclusion: NFPA with cavernous sinus invasion. Exclusion: grade 1 and 2 according to Knosp; patients who had previously been treated with radiotherapy in the pituitary region; patients with follow-up shorter than 36 months. (2000–2010) | 56 | median: 59 (37–79) | 20 (36%) | NF 56 (100%) | 34 > 1 cm, 22 > 4 cm | 17/56 (30%) |
| Han (2013) | Retrospective case series | Inclusion: PA, endoscopic endonasal approach (2009–2012) | 250 | Mean age: 43.8 (–) | 151 (60%) | NF 147 (58.8%), PRL 33 (13.2%), GH 42 (16.8%), ACTH 20 (8%), TSH 3 (1.2%), mixed 5 (2%) | 116 Macroadenomas | 250 (86%) |
| Jho (1997) | Retrospective case series | Inclusion: PA endoscopic endonasal approach (1993–1995) | 15 | Median age: 43 (range 17–88) | 9 (60%) | NF 6 (40%), PRL 5 (33.3%), ACTH 3 (20%), adenoma 1 (6.7%) | NS | NS |
| Koutourousiou (2013) | Retrospective case series | Inclusion: giant PA with diameter >4 cm (2002–2011) | 54 | Mean age: 53 (–) | 8 (15%) | NS | Mean: 32.88 cm3 (–) | 11 (20%) |
| Kuo (2016) | Retrospective case series | Inclusion: giant PA size (> 4 cm in at least 1 direction or estimated tumor volume > 10 cm3) (2002–2009) | 38 | Mean age: 51 (SD: 13) | 23 (60%) | NS | Mean: 3.2 cm3 (SD: 4.6) | 38 (21%) |
| Marenco (2011) | Retrospective case series | Inclusion: PA: >65 years old, non-functioning (2001–2013) | 25 | Mean age: 72 (SD: 5) | 14 (56%) | NF 25 (100%) | Mean: 3.4 cm (SD: 7.3) | 25 (31%) |
| Sabry (2015) | Retrospective case series | Inclusion: endonasally operated PA | 40 | Median: 48 years (range 18–81) | 18 (45%) | NS | Volume: 9.48 cm3 (SD 12.7) | 33 (83%) |
| Wongsirisuwan (2014) | Retrospective case series | Inclusion: PA operated with keyhole and endonasal approach (2003–2013) | 38/130 | NS | NS | NS | NS | NS |
| Zhan (2015) | Retrospective case series | Inclusion: PA patients resected endoscopically (2008–2014) | 313 | NS | 125 (39%) | NS | NS | 239 (75%) |
NS not specified, SD standard deviation, NF non-functioning, ACHT adrenocorticotrophic hormone, GH growth hormone, TSH thyroid stimulating hormone, PRL prolactinoma, PA pituitary adenoma