• Xiaoqing Li, Wei Wu, Qing Miao, Min He, Shuo Zhang, Zhaoyun Zhang, Bin Lu, Yehong Yang, Xuefei Shou, Yiming Li, Yongfei Wang, and Hongying Ye.
• Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.
• World Neurosurg. 2019 Jan 1; 121: e8-e14.

ObjectiveCraniopharyngiomas have traditionally been resected through the transcranial approaches (TCA). The endoscopic endonasal approach (EEA) has recently been developed as an alternative for surgeons, but controversy remains regarding which approach has better outcomes. We compared the endocrine and metabolic outcomes of TCA and EEA in patients who underwent primary resection of craniopharyngiomas.MethodsA retrospective analysis was conducted of patients with craniopharyngioma who were treated by the department of endocrinology and metabolism at our institution between 2011 and 2015.ResultsOf 43 patients assessed, 26 underwent TCA and 17 underwent EEA. After surgery, 29.4% (5/17) of patients in the EEA group had normal anterior pituitary function, whereas none in the TCA group had complete anterior pituitary function. Higher prevalences of corticotropic deficiency (92.3% vs. 52.9%, P = 0.009), thyrotrophic deficiency (96.2% vs. 52.9%, P = 0.003), and hypogonadotropic hypogonadism (100% vs. 70.6%, P = 0.014) were found in the TCA group. The TCA group showed a trend toward having more patients with at least 3 anterior pituitary deficits (88.5% vs. 58.8%, P = 0.060). The mean body mass index at last follow-up tended to be lower in the EEA group (24.13 ± 3.16 kg/m2 vs. 26.79 ± 4.5 kg/m2, P = 0.079), and the preoperative body mass index was comparable between groups. Similar prevalences of overweight/obesity, hypertension, hyperglycemia, and metabolic syndrome were detected in the 2 groups. Moreover, no significant differences were observed in the rates of cerebrospinal fluid leakage and intracranial infection between the 2 groups.ConclusionsEEA may provide the same gross total resection rate for craniopharyngioma as TCA while providing better protection of anterior pituitary function.Copyright © 2018 Elsevier Inc. All rights reserved.

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