Endoscopic pituitary surgery: National database review

Head Neck. 2022 Dec;44(12):2678-2685. doi: 10.1002/hed.27179. Epub 2022 Aug 30.

Abstract

Background: Pituitary tumors surgery is increasingly performed via endoscopic transsphenoidal approach (TSP). This study describes outcomes of TSP surgery in the United States.

Methods: A retrospective cross-sectional analysis of adult patients with pituitary adenoma was performed using the Nationwide Readmissions Database, 2010-2015.

Results: A total of 5891 patients were identified. The average age was 51.29 ± 0.29 years. The risk of postoperative epistaxis, diabetes insipidus, cerebrospinal fluid (CSF) leak, and other general postoperative complications was 0.71%, 10.20%, 8.35%, and 2.37%, respectively. Independent risk factors of CSF leak included: age <65-year, male, body mass index ≥25, and multiple comorbidities (p < 0.001 each). The prevalence of CSF leak was not associated with hospital TSP volume and teaching status.

Conclusion: This study provides a national epidemiological perspective on TSP in the United States. The risk of postoperative CSF leak appears to be associated with intrinsic patient factors rather than resource and expertise availability.

Keywords: cerebrospinal fluid leak; complications; epidemiology; pituitary adenoma; surgery; transsphenoidal.

MeSH terms

  • Adult
  • Cerebrospinal Fluid Leak / epidemiology
  • Cerebrospinal Fluid Leak / etiology
  • Cerebrospinal Fluid Leak / surgery
  • Cross-Sectional Studies
  • Humans
  • Male
  • Middle Aged
  • Pituitary Diseases* / complications
  • Pituitary Diseases* / surgery
  • Pituitary Neoplasms* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies