SynthesisPituitary2018
Preoperative risk factors for postoperative complications in endoscopic pituitary surgery: a systematic review.
Synthesis in Pituitary, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 5 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- The incidence of postoperative cerebrospinal fluid leakage after elective cranial surgery: a systematic review.Neurosurgical review · 2022Pooled it
- Factors Influencing Cerebrospinal Fluid Leaking following Pituitary Adenoma Transsphenoidal Surgery: A Meta-Analysis and Comprehensive Review.BioMed research international · 2022Pooled it
- Risk factors for postoperative cerebrospinal fluid leakage after transsphenoidal surgery for pituitary adenoma: a meta-analysis and systematic review.BMC neurology · 2021Pooled it
- Trends in cerebrospinal fluid leak rates following the extended endoscopic endonasal approach for anterior skull base meningioma: a meta-analysis over the last 20 years.Acta neurochirurgica · 2021Pooled it
- Risk factors for the progression of finger interphalangeal joint osteoarthritis: a systematic review.Rheumatology international · 2020Pooled it
- Sex-related differences in healthcare utilization and costs among patients with pituitary adenomas.Pituitary · 2026Review
- Should positive airway pressure be continued uninterrupted after endoscopic skull base surgery? A review of current literature.Journal of sleep research · 2026Review
- Continuous white-light/indocyanine green overlay endoscopy in pituitary adenoma surgery: A prospective feasibility and safety study.Brain & spine · 2026Article
- Predictors, Complications, and Clinical Outcomes of Cerebrospinal Fluid Leak Post Endoscopic Endonasal Skull Base Surgery.Brain sciences · 2025Article
- Article
- Article
- Complications following endoscopic transsphenoidal surgery for pituitary adenoma-special focus on intrasellar pressure.Acta neurochirurgica · 2025Observational
- Risk Factors for Development of Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Transsphenoidal Resection of Pituitary Adenoma.Journal of neurological surgery. Part B, Skull base · 2025Article
- Operative considerations for resection of pituitary adenoma in patients with sickle cell disease: A retrospective analysis of 19,653 patients.Surgical neurology international · 2025Article
- Letter to the editor: "Endonasal endoscopic or endoscopic-assisted transcranial surgery of Rathke's cleft cysts: does the approach and surgical technique influence the radicality and recurrence rate?"Neurosurgical review · 2024Article
- The Predictors of Postoperative Cerebrospinal Fluid Leak in Endoscopic Endonasal Pituitary Surgery: The Role of Tumor Volume.Journal of neurological surgery. Part B, Skull base · 2024Article
- Predictors and Complications of Cerebrospinal Fluid Leak after Endoscopic Endonasal Surgery: A Single Institution Retrospective Review.Journal of neurological surgery. Part B, Skull base · 2024Article
- Impact of metabolic syndrome on postoperative outcomes of transsphenoidal pituitary surgery: analysis of U.S. nationwide inpatient sample data 2005-2018.Frontiers in endocrinology · 2024Observational
- Morphometric analysis of transsphenoidal surgery in Peruvian population.Surgical neurology international · 2024Review
- Tips and Tricks to Safely Perform an Endoscopic Endonasal Trans-Sphenoidal Pituitary Surgery: A Surgeon's Checklist.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe ability to preoperatively predict postoperative complication risks is valuable for individual counseling and (post)operative planning, e.g. to select low-risk patients eligible for short stay surgery or those with higher risks requiring special attention. These risks however, are not well established in pituitary surgery.
methodsWe conducted a systematic review of associations between preoperative characteristics and postoperative complications of endoscopic transsphenoidal surgery according to the PRISMA guidelines. Risk of bias was assessed through the QUIPS tool.
resultsIn total 23 articles were included, containing 5491 patients (96% pituitary adenoma). There was a wide variety regarding the nature and number of risk factors, definitions, measurement and statistics employed, and overall quality of mainly retrospective studies was low. Consistent significant associations were older age for complications in general, and intraventricular extension for cerebrospinal fluid (CSF) leaks. Associations identified in some but not all studies were younger age, increased BMI, female gender, and learning curve for CSF leaks; increased tumor size for complications in general; and Rathke's cleft cysts for diabetes insipidus. Mortality (incidence rate 1%) was not addressed as a risk factor.
conclusionBased on current literature, of low to medium quality, it is not possible to comprehensively quantify risk factors for complications. Nevertheless, older age and intraventricular extension were associated with increased postoperative complications. Future research should aim at prospective data collection, reporting of outcomes, and uniformity of definitions. Only then a proper risk analysis can be performed for endoscopic pituitary surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.