Pineal region tumors are extremely deep-seated and surgically challenging. The exposure and visualization obtained by microscopic surgery are relatively limiting. The application of high-definition endoscopes has recently provided neurosurgeons with a much more magnified and clearer view of the anatomy in the pineal region. The present study was performed to compare endoscopic-assisted surgery (ES) with microsurgery (MS) for pineal region tumors. We retrospectively analyzed patients admitted to our hospital for treatment of pineal region tumors from January 2016 to June 2019. All patients consented to undergo tumor resection with ES or MS. We compared the extent of resection, postoperative rate of hydrocephalus, complications, and outcomes between the two groups to estimate the safety and efficacy of ES. In total, 41 patients with pineal region tumors were divided into 2 groups: the ES group (n = 20) and MS group (n = 21). The rate of gross total resection was significantly higher in the ES than MS group (90.0% vs. 57.1%, p = 0.04). The rate of postoperative hydrocephalus was significantly lower in the ES than MS group (11.8% vs. 52.9%, p = 0.03). No significant differences were found in complications or the Karnofsky Performance Score between the two groups. ES can be used to safely and effectively achieve complete resection of pineal region tumors. In patients with obstructive hydrocephalus, ES provides a new way to directly open the aqueduct for cerebrospinal fluid recovery following tumor resection.

松果体肿瘤根深蒂固，手术难度大。通过显微手术获得的曝光和可视化是相对有限的。高清晰度内窥镜的应用近来为神经外科医师提供了松果体区域的解剖结构的更加放大和清晰的视图。进行本研究以比较内镜辅助手术（ES）与显微外科手术（MS）对松果体区域肿瘤的影响。我们回顾性分析了2016年1月至2019年6月入院治疗松果体区域肿瘤的患者。所有患者均同意接受ES或MS肿瘤切除术。我们比较了两组的切除程度，脑积水的术后发生率，并发症和结局，以评估ES的安全性和有效性。总共，n  = 20）和MS组（n  = 21）。ES的总切除率显着高于MS组（90.0％对57.1％，p  = 0.04）。ES组术后脑积水发生率明显低于MS组（11.8％vs. 52.9％，p  = 0.03）。两组之间在并发症或卡诺夫斯基绩效评分方面没有发现显着差异。ES可用于安全有效地完全切除松果体区域肿瘤。对于梗阻性脑积水患者，ES提供了一种新的方法来直接打开导尿管以切除肿瘤后的脑脊液。