Complication Rates after Endoscopic Transsphenoidal Surgery for ACTH-Secreting Pituitary Adenomas: A Comparative Analysis with GH and Nonfunctioning Adenomas
| Autor: | Juan R. Gras-Cabrerizo, Carlos Asencio-Cortés, Susan M. Webb, Fernando Muñoz-Hernández, Juan Ángel Aibar-Durán, Elena Valassi, Pere Tresserras Ribó, Joan Monserrat-Gili, Michael Oladotun-Anka |
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| Rok vydání: | 2021 |
| Předmět: |
Transsphenoidal surgery
medicine.medical_specialty ACTH-Secreting Pituitary Adenoma Multivariate analysis complications Adenoma business.industry medicine.medical_treatment pituitary adenoma 030209 endocrinology & metabolism medicine.disease Gastroenterology ACTH-secreting adenomas 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Internal medicine Diabetes insipidus medicine Neurology (clinical) Complication business endoscopic transsphenoidal surgery 030217 neurology & neurosurgery Hormone |
| Zdroj: | Journal of Neurological Surgery Part B-Skull Base r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau Instituto de Salud Carlos III (ISCIII) J Neurol Surg B Skull Base |
| ISSN: | 2193-634X 2193-6331 |
| DOI: | 10.1055/s-0041-1725029 |
| Popis: | Objectives Some complications have been more frequently reported after surgery for adrenocorticotropin hormone (ACTH)-secreting pituitary adenomas. We compared complication rates in patients with ACTH-secreting pituitary adenomas with those in patients with growth hormone secreting pituitary adenomas (growth hormone [GH] group) and nonfunctioning adenomas (nonfunctioning group). Design A comparative three-group analysis was performed for all patients who had endoscopic transsphenoidal surgery for pituitary adenomas at our center between January 2011 and May 2019. Variables included demographics, preoperative clinical and radiological characteristics, and postoperative radiological and endocrinological outcomes. Complications were divided into four categories: endocrinological, neurosurgical, medical, and ENT (ear–nose–throat)-related complications. Univariate and multivariate statistical analysis were performed. Results A total of 111 patients with pituitary adenomas and a mean age of 53.7 years were included (25 ACTH, 35 GH, and 51 nonfunctioning adenomas). Overall, 28 patients had microadenomas (25.2%) and 83 had macroadenomas (74.8%). Univariate statistical analysis for complications between groups showed no differences in neurosurgical and medical complications. Transient diabetes insipidus and postsurgical bacterial sinusitis were the only variables more frequently seen in the ACTH group (p = 0.01 and 0.04, respectively). Multivariate analysis for transient diabetes insipidus showed no differences between groups (p = 0.58). Conclusion Complication rates were similar in all three adenoma groups, particularly concerning major infections, thrombotic events, postoperative cerebrospinal fluid (CSF) leak, and transient diabetes insipidus. Transient diabetes insipidus was related with adenoma size and intraoperative CSF leak. Despite postoperative bacterial sinusitis was statistically higher in the ACTH group, this data should be interpreted with caution given the low number of patients with this complication. |
| Databáze: | OpenAIRE |
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