Background
Microscopic and endoscopic approaches are both utilized for transsphenoidal resection of sellar/parasellar lesions. The endoscopic approach has been gaining popularity over the past ...decade; however, quality-of-life studies comparing the microscopic and endoscopic approaches are lacking. We aimed to compare the patients’ perceptions of their postoperative recovery periods following microscopic and endoscopic procedures.
Methods
Qualitative research methodology was used for this study. Each participant underwent a single semi-structured, open-ended interview based on an interview guide. Each participant had undergone at least one microscopic and one endoscopic transsphenoidal procedure for resection of a sellar/parasellar lesion. The interviews were audiotaped and transcribed. The transcripts were then analyzed for overarching themes. Demographic information was also collected.
Results
The following five overarching themes emerged from the data: (1) the endoscopic procedure was better tolerated than the microscopic procedure and was the preferred approach by 22 out of 27 patients should they require another surgery in the future; (2) most patients did not know that they had undergone two different surgical approaches; (3) other than an unpleasant malodorous smell, rhinologic complications (including drainage, crusting, and alterations in smell) following the endoscopic procedures were comparable to those following the microscopic procedures; (4) the patient’s postoperative experience after the microscopic procedure had an impact on his/her expectations of the endoscopic procedure; (5) any significant pain or discomfort experienced from either procedure was mainly related to the nasal packing or fascia lata graft donor site.
Conclusions
The endoscopic procedure was the preferred approach over the microscopic approach by the majority of patients because of its better tolerability, despite comparable rhinologic complications.
Abstract
Background. Endoscopic transsphenoidal surgery has been shown to be a safe and effective treatment option for patients with pituitary tumours, but no study has explored patients' perceptions ...before and after this surgery. Objective. The authors in this study aim to explore patients' perceptions on endoscopic transsphenoidal surgery. Methods. Using qualitative research methodology, two semi-structured interviews were conducted with 30 participants who were adults aged > 18 undergoing endoscopic transsphenoidal surgery for the resection of a pituitary tumour between December 2008 and June 2011. The interviews were audiotaped and transcribed. The resulting data was analyzed using a modified thematic analysis. Results. Seven overarching themes were identified: (1) Patients had a positive surgical experience; (2) patients were satisfied with the results of the procedure; (3) patients were initially surprised that neurosurgery could be performed endonasally; (4) patients expected a cure and to feel better after the surgery; (5) many patients feared that something might go wrong during the surgery; (6) patients were psychologically prepared for the surgery; (7) most patients reported receiving adequate pre-op and post-op information. Conclusions. This is the first qualitative study reporting on patients' perceptions before and after an endoscopic endonasal transsphenoidal pituitary surgery, which is increasingly used as a standard surgical approach for patients with pituitary tumours. Patients report a positive perception and general satisfaction with the endoscopic transsphenoidal surgical experience. However, there is still room for improvement in post-surgical care. Overall, patients' perceptions can help improve the delivery of comprehensive care to future patients undergoing pituitary tumour surgery.
Background:
Endoscopic transsphenoidal surgery had been shown to be a safe and effective treatment option for patients with pituitary tumors, but there has been no study exploring patients' ...perceptions before and after this surgery.
Objective:
The authors in this study aim to explore patients' perceptions on endoscopic transsphenoidal surgery.
Methods:
Using a qualitative research methodology, two semistructured interviews were conducted with 30 participants. These participants were adults older than 18 years who underwent endoscopic endonasal transsphenoidal surgery for the resection of a pituitary tumor between December 2008 and June 2011. The open-ended interviews were audiotaped and transcribed and the resulting data was analyzed using a modified thematic analysis.
Results:
The following seven overarching themes were identified from the data: (1) Patients had a positive surgical experience; (2) patients were satisfied with the results of the procedure; (3) patients were initially surprised that neurosurgery could be performed endonasally; (4) patients expected a cure and to feel better after the surgery; (5) many patients feared that something might go wrong during the surgery; (6) patients were psychologically prepared for the surgery; (7)most patients reported receiving adequate preoperative and postoperative information.
Conclusions:
This is the first qualitative study reporting on patients' perceptions before and after an endoscopic endonasal transsphenoidal pituitary surgery, which is increasingly used as a standard surgical approach for patients with pituitary tumors. Patients report a positive perception and general satisfaction with the endoscopic endonasal transsphenoidal surgical experience, both preoperatively and postoperatively. However, there is still room for improvement in postsurgical care. Overall, patients' perceptions can help improve the delivery of comprehensive care to future patients undergoing pituitary tumor surgery.
