ArticlePituitary2021
Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients.
Article in Pituitary, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Improved visual outcomes after endoscopic endonasal transsphenoidal surgery for pituitary macroadenomas: a single-arm meta-analysis.Acta neurochirurgica · 2026Pooled it
- Incidence and risk factors of hyponatremia after transsphenoidal surgery: a systematic meta-analysis.Neurosurgical review · 2025Pooled it
- Intraoperative cerebrospinal fluid leakage and residual tumors in endoscopic transsphenoidal surgery for pituitary adenoma: risk analysis and nomogram development.Acta neurochirurgica · 2023Trial
- Ageing and pituitary neuroendocrine tumours (PitNETs): from bench to bedside.Endocrine-related cancer · 2026Review
- Impact of nasal septal deviation on surgical outcomes in endoscopic transsphenoidal surgery: a population-based study.Pituitary · 2025Article
- Contributing factors to postoperative surgical site infections in pituitary neuroendocrine tumors undergoing endonasal transsphenoidal resection.Scientific reports · 2025Article
- Assessing surgical outcomes in pituitary adenoma: A comparison of microscopic and endoscopic techniques.Surgical neurology international · 2025Article
- Endoscopic endonasal transcavernous approach for removal of pituitary macroadenoma with apoplexy: Technical nuances.Surgical neurology international · 2025Article
- Visual outcomes and optimal timing for repeat surgery in cases of postoperative hematoma following transsphenoidal surgery for pituitary neuroendocrine tumors: A retrospective cohort study.Acta neurochirurgica · 2024Article
- The RAPID Consortium: A Platform for Clinical and Translational Pituitary Tumor Research.Journal of neurological surgery. Part B, Skull base · 2024Article
- Endoscopic Transsphenoidal Surgery with a Layered Peel Strategy for Cushing's Disease Treatment: A Case Series.Brain sciences · 2023Article
- Diagnostic Pitfalls in Cushing Disease: Surgical Remission Rates, Test Thresholds, and Lessons Learned in 105 Patients.The Journal of clinical endocrinology and metabolism · 2022Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the impact of using consistent complication-avoidance protocols in patients undergoing endoscopic pituitary adenoma surgery including techniques for avoiding anosmia, epistaxis, carotid artery injury, hypopituitarism, cerebrospinal fluid leaks and meningitis.
methodsAll patients undergoing endoscopic adenoma resection from 2010 to 2020 were included. Primary outcomes included 90-day complication rates, gland function outcomes, reoperations, readmissions and length of stay. Secondary outcomes were extent of resection, short-term endocrine remission, vision recovery.
resultsOf 514 patients, (mean age 51 ± 16 years; 78% macroadenomas, 19% prior surgery) major complications occurred in 18(3.5%) patients, most commonly CSF leak (9, 1.7%) and meningitis (4, 0.8%). In 14 of 18 patients, complications were deemed preventable. Four (0.8%) had complications with permanent sequelae (3 before 2016): one unexplained mortality, one stroke, one oculomotor nerve palsy, one oculoparesis. There were no internal carotid artery injuries, permanent visual worsening or permanent anosmia. New hypopituitarism occurred in 23/485(4.7%). Partial or complete hypopituitarism resolution occurred in 102/193(52.8%) patients. Median LOS was 2 days; 98.3% of patients were discharged home. Comparing 18 patients with major complications versus 496 without, median LOS was 7 versus 2 days, respectively p < 0.001. Readmissions occurred in 6%(31/535), mostly for hyponatremia (18/31). Gross total resection was achieved in 214/312(69%) endocrine-inactive adenomas; biochemical remission was achieved in 148/209(71%) endocrine-active adenomas. Visual field or acuity defects improved in 126/138(91.3%) patients.
conclusionThis study suggests that conformance to established protocols for endoscopic pituitary surgery may minimize complications, re-admissions and LOS while enhancing the likelihood of preserving gland function, although there remains opportunity for further improvements.
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