Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas

TLDR

Transsphenoidal surgery is generally safe but serious complications still occur, and further improvement is expected with more experience and new technical developments. The study retrospectively assessed postoperative complications in 146 patients undergoing endoscopic endonasal transsphenoidal surgery for pituitary adenomas from 1997 to 2001. Complications were categorized into nasofacial, sphenoid sinus, sella turcica, supra/parasellar, and endocrine groups based on involved anatomy and systems. The study found a lower complication rate than historical microsurgical series, likely due to better anatomical visualization and less trauma, and recommends a coordinated multidisciplinary team. No additional metadata available.

Abstract

Object. To assess postoperative complications related to the surgical procedure, a retrospective analysis was conducted in a series of 146 consecutively treated patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of pituitary adenomas between January 1997 and July 2001. Methods. Complications were divided into groups (nasofacial, sphenoid sinus, sella turcica, supra or parasellar, and endocrine complications) according to the anatomical structures and the systems involved. Overall, a decreased incidence of complications has been observed, compared with large historical series of the traditional microsurgical transsphenoidal approach, likely because of the overview inside the anatomy facilitated by the endoscope, and the decreased surgical trauma. Conclusions. Transsphenoidal surgery, either microscopic or endoscopic, is a safe procedure in experienced hands, but serious complications still occur and must be reduced as much as possible. Additional improvement can be expected with greater experience and new technical developments. A coordinated team effort with other dedicated colleagues from different specialties is advised.