Avoiding complications in endoscopic trans-sphenoidal surgery for pituitary adenoma: A beginner's perspective

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Introduction: We aimed to analyze the difficulties and complications experienced while as a beginner in endoscopic transnasal transsphenoidal approach for pituitary adenomas. Materials and Methods: We retrospectively analyzed 83 cases done from June 2016 to August 2019. Navigation-guided endoscopic transnasal transsphenoidal approach was used in all the cases. Results: Gross total tumor removal was achieved in 55 (66.26%) patients. We found that gross total resection rate was inversely proportional to Knosp grading, and the extent of resection was found to have a statistically significant correlation with grade of tumor (P < 0.05). Surgery-related complications were present in 33 of our patients. Nasal complications occurred in six patients: three epistaxis (3.6%) and two hyposmia (2.4%) and one case of septal hematoma (1.2%). Postoperative cerebrospinal fluid leak occurred in six (7.2%) cases, two (2.4%) cases had sinusitis, while two (2.4%) cases had meningitis. There was a very rare case of subarachnoid hemorrhage and one case had sellar hematoma. Endocrinologic complications occurred in 15 (18.07%) patients: anterior pituitary deficiency in five (6.02%) patients, transient diabetes insipidus (DI) in nine (10.84%) patients, and permanent DI in one (1.2%) patient. There was no vascular injury or mortality noted in our study. Conclusion: Endoscopic approach is an effective modality for pituitary surgery; with patience, learning lessons from your own mistakes and by adopting right technique, learning curve can be flattened significantly.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Avoiding complications in endoscopic trans-sphenoidal surgery for pituitary adenoma: A beginner's perspective ; volume:15 ; number:04 ; year:2020 ; pages:899-907
Asian journal of neurosurgery ; 15, Heft 04 (2020), 899-907

Beteiligte Personen und Organisationen
Goyal, Pawan
Gupta, Aditya
Srivastava, Sanjeev
Modi, Shilpi

DOI
10.4103/ajns.AJNS_121_20
URN
urn:nbn:de:101:1-2023011916025469615487
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:24 MESZ

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Beteiligte

  • Goyal, Pawan
  • Gupta, Aditya
  • Srivastava, Sanjeev
  • Modi, Shilpi

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