Related Experiment Video
Updated: Sep 4, 2025
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
19.0K
Complication Rates after Endoscopic Transsphenoidal Surgery for ACTH-Secreting Pituitary Adenomas: A Comparative
Juan Á Aibar-Durán1, Michael Oladotun-Anka1, Carlos Asencio-Cortés1
1Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain), Autonomous University of Barcelona (AUB), Barcelona, Spain.
Journal of Neurological Surgery. Part B, Skull Base
|July 14, 2022
Summary
Complication rates after pituitary adenoma surgery were similar across ACTH-secreting, growth hormone-secreting, and nonfunctioning adenomas. Transient diabetes insipidus and sinusitis were slightly higher in the ACTH group but not significant in multivariate analysis.
Area of Science:
- Neurosurgery
- Endocrinology
- Otolaryngology
Background:
- Endoscopic transsphenoidal surgery is common for pituitary adenomas.
- Certain complications are anecdotally reported more frequently after surgery for adrenocorticotropin hormone (ACTH)-secreting pituitary adenomas.
- Comparative data on complication rates across different pituitary adenoma types is limited.
Purpose of the Study:
- To compare complication rates in patients undergoing endoscopic transsphenoidal surgery for ACTH-secreting pituitary adenomas versus those with growth hormone (GH)-secreting or nonfunctioning pituitary adenomas.
- To identify specific complications that may be more prevalent in the ACTH-secreting group.
Main Methods:
- A comparative three-group analysis of 111 patients who underwent endoscopic transsphenoidal surgery for pituitary adenomas between 2011 and 2019.
- Data collected included demographics, clinical and radiological characteristics, and postoperative outcomes.
- Complications were categorized into endocrinological, neurosurgical, medical, and ear-nose-throat (ENT)-related, with univariate and multivariate statistical analyses performed.
Main Results:
- No significant differences were observed in overall neurosurgical or medical complication rates between the ACTH, GH, and nonfunctioning adenoma groups.
- Transient diabetes insipidus and postsurgical bacterial sinusitis were more frequent in the ACTH group (p=0.01 and p=0.04, respectively) in univariate analysis.
- Multivariate analysis revealed no significant difference in transient diabetes insipidus between groups (p=0.58), which was associated with adenoma size and intraoperative CSF leak.
Conclusions:
- Overall complication rates, including major infections, thrombotic events, CSF leaks, and transient diabetes insipidus, were similar across the three pituitary adenoma groups.
- While postsurgical bacterial sinusitis was statistically higher in the ACTH group, this finding should be interpreted cautiously due to the small number of cases.
- Adenoma size and intraoperative CSF leak were identified as risk factors for transient diabetes insipidus.
