内窥镜鼻内经蝶手术（EETS）是鞍区和鞍上肿瘤的常见治疗方法。虽然内窥镜培训多年来得到了改善，并且正式的专科培训现已广泛提供，但 EETS 的操作细微差别推测，随着神经外科医生随着经验的成熟，存在学习曲线。我们的目标是评估同一机构中三种不同经验水平的神经外科医生随着时间的推移的手术结果。我们回顾了 2007 年以来在洛约拉大学医学中心接受 EETS 的所有成年患者，其中包括三名职业早期、一名职业中期和两名职业晚期神经外科医生到 2023 年。使用手术时间、总切除率 (GTR) 和症状改善率 (SI)、术后新的类固醇依赖以及糖尿病的发生等指标对患者人口统计、肿瘤特征和手术结果进行比较评估尿崩症（DI）。使用 T 检验和卡方对研究队列进行统计评估。共有 297 名患者接受了 EETS。 103 例（35%）由职业生涯早期的神经外科医生进行手术，122 例（41%）由职业生涯中期的神经外科医生进行手术，72 例（24%）由职业生涯晚期的神经外科医生进行手术。职业生涯晚期的外科医生手术时间较短（职业生涯早期和中期为 144 分钟 vs. 180 分钟，p=0.029）并且 GTR 率增加（p=0.008）。不同外科医生经验水平之间的 SI 率没有显着差异。尽管在统计上不显着，但早期职业神经外科医生的术后新类固醇依赖率较低。早期职业外科医生的患者经历的 DI 显着减少（15% vs 40%，p=0.004）。职业生涯后期的神经外科医生手术时间较短，GTR 发生率较高，并且患者的 DI 发生率显着较高。在 16 年的时间里，不同外科医生经验水平之间的总体结果保持稳定。由 Elsevier Inc. 出版。

Endoscopic endonasal transsphenoidal surgery (EETS) is a common treatment for sellar and suprasellar tumors. While endoscopic training has improved over the years and formal fellowship training is now broadly available, the operative nuances of EETS conjectures the existence a learning curve as a neurosurgeon matures with experience. We aim to evaluate operative outcomes of three different experience levels of neurosurgeons over time at a single institution.We reviewed all adult patients who underwent EETS at Loyola University Medical Center by three early career, one mid-career, and two late career neurosurgeons from 2007 to 2023. A comparative assessment of patient demographics, tumor features, and surgical outcomes was done using metrics such as length of surgery, rates of gross total resection (GTR) and symptomatic improvement (SI), new postoperative steroid dependence, and development of diabetes insipidus (DI). T-tests and Chi-Square were used to statistically evaluate the study cohorts.A total of 297 patients underwent EETS. One hundred and three (35%) were operated on by an early career, 122 (41%) by a mid-career, and 72 (24%) by a late career neurosurgeon. Late-career surgeons had shorter operation times (144 vs. 180 minutes with early and mid-career, p=0.029) and increased GTR rates (p=0.008). There were no significant differences between the SI rates amongst various surgeon experience levels. Although not statistically significant, early-career neurosurgeons had lower rates of new postoperative steroid dependence. Patients of early career surgeons experienced significantly less DI (15% vs 40%, p=0.004).Late-career neurosurgeons had shorter operation lengths, achieved higher rates of GTR, and their patients experienced significantly higher rates of DI. Overall outcomes remained stable throughout the course of 16 years between different surgeon experience levels.Published by Elsevier Inc.