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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Endoscopic pituitary surgery: National database review.
Zaid Al-Qurayshi1, Douglas M Bennion1, Jeremy D W Greenlee1,2
1Department of Otolaryngology-Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Head & Neck
|August 30, 2022
Summary
Endoscopic transsphenoidal pituitary tumor surgery outcomes in the US show CSF leak risk is linked to patient factors, not hospital resources. This impacts understanding pituitary adenoma treatment strategies.
Area of Science:
- Neurosurgery
- Endocrinology
- Epidemiology
Background:
- Endoscopic transsphenoidal approach (TSP) is a common surgical method for pituitary tumors.
- Understanding TSP surgery outcomes is crucial for patient care and treatment planning.
Purpose of the Study:
- To describe the outcomes of endoscopic transsphenoidal pituitary tumor surgery in the United States.
- To identify risk factors associated with postoperative complications, particularly cerebrospinal fluid (CSF) leak.
Main Methods:
- Retrospective cross-sectional analysis of adult patients with pituitary adenoma.
- Data sourced from the Nationwide Readmissions Database (2010-2015).
Main Results:
- 5891 patients were analyzed; average age was 51.29 years.
- Postoperative complication risks: epistaxis (0.71%), diabetes insipidus (10.20%), CSF leak (8.35%), general complications (2.37%).
- Independent risk factors for CSF leak included younger age (<65), male sex, BMI ≥25, and multiple comorbidities (p < 0.001). CSF leak was not associated with hospital TSP volume or teaching status.
Conclusions:
- This study offers a national epidemiological view of TSP in the US.
- The risk of postoperative CSF leak is primarily associated with intrinsic patient factors, not hospital-related resources or expertise.
