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Updated: Nov 27, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy under endoscope
1Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Department of Neurosurgery, Nanjing 210000, Jiangsu Province, P. R. China.
Background And Purpose:
Background - Up to now, the risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy remain controversial. Purpose - To analyze the risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy under an endoscope, and to provide evidence for preventing and controlling the occurrence and development of infections.
Methods:
A total of 370 patients receiving endoscopic transsphenoidal pituitary adenomectomy in our hospital from January 2014 to October 2017 were selected. The risk factors related to postoperative intracranial infections were analyzed. The hospitalization lengths and expenditures of patients with and without intracranial infections were compared.
Results:
Of the 370 patients, 18 underwent postoperative intracranial infections, with the infection rate of 4.86%. Intraoperative blood loss >120 mL, cerebrospinal leakage, diabetes, preoperative use of hormones, macroadenoma as well as surgical time >4 h all significantly increased the infection rate (P<0.05). Preoperative use of antibacterial agents prevented intracranial infection. Compared with patients without intracranial infections, the infected ones had significantly prolonged hospitalization length and increased expenditure (P<0.05). Discussion - It is of great clinical significance to analyze the risk factors related to intracranial infection after endoscopic transsphenoidal pituitary adenomectomy, aiming to prevent and to control the onset and progression of infection.
Conclusion:
Intracranial infections after endoscopic transsphenoidal pituitary adenomectomy were affected by many risk factors, also influencing the prognosis of patients and the economic burden.
Insights
Postoperative intracranial infections after endoscopic pituitary surgery are linked to factors like blood loss and diabetes. Preoperative antibiotics may prevent these infections, which worsen patient outcomes and increase costs.
Area of Science:
- Neurosurgery
- Infectious Disease Epidemiology
Background:
- Intracranial infections following transsphenoidal pituitary adenomectomy are a significant concern.
- Existing research on risk factors remains inconclusive, necessitating further investigation.
Purpose of the Study:
- To identify and analyze risk factors associated with intracranial infections after endoscopic transsphenoidal pituitary adenomectomy.
- To provide evidence-based recommendations for preventing and managing these infections.
Main Methods:
- A retrospective analysis of 370 patients who underwent endoscopic transsphenoidal pituitary adenomectomy between January 2014 and October 2017.
- Statistical analysis to determine risk factors for postoperative intracranial infections and compare outcomes between infected and non-infected groups.
Main Results:
- The incidence of postoperative intracranial infections was 4.86% (18 out of 370 patients).
- Significant risk factors included intraoperative blood loss (>120 mL), cerebrospinal fluid leakage, diabetes, preoperative hormone use, macroadenoma, and prolonged surgical time (>4 hours).
- Preoperative antibiotic use was associated with a reduced infection rate, while infected patients experienced longer hospital stays and higher costs.
Conclusions:
- Multiple risk factors contribute to intracranial infections after endoscopic transsphenoidal pituitary adenomectomy.
- These infections negatively impact patient prognosis and impose a substantial economic burden.
