Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients
| Autor: | Wladia Sobreira, Meissa T. Kretzmann, Lucas Alverne Freitas de Albuquerque, Tania Ferraz, Jackson A. Gondim, Michele Schops, Joao Paulo Almeida, Erika Gomes |
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| Rok vydání: | 2010 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Endoscope Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment Nose Neurosurgical Procedures Cohort Studies Young Adult Endocrinology Hematoma Postoperative Complications Pituitary adenoma Posterior pituitary Sphenoid Bone medicine Humans Pituitary Neoplasms Child Aged Retrospective Studies Transsphenoidal surgery medicine.diagnostic_test business.industry Pituitary tumors Endoscopy Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Female business |
| Zdroj: | Pituitary. 14(2) |
| ISSN: | 1573-7403 |
| Popis: | The authors investigate the complications of transnasal transsphenoidal endoscopic surgery in the treatment of 301 patients with pituitary adenomas. A retrospective analysis of complications in 301 patients submitted to transsphenoidal transnasal endoscopic surgery at the General Hospital of Fortaleza, Brazil between January 1998 and December 2009. The complications were divided in two groups: anatomical (oronasofacial, sphenoid sinus, intrasellar, suprasellar and parasellar) and endocrinological complications (anterior and posterior pituitary dysfunctions). We observed a total of 81 complications (26.9%) in our series. Anatomical complications occurred in 8.97% (27 cases): 8 CSF postoperative leaks (2.6%), 6 cases (1.9%) of delayed nasal bleeding, 5 cases (1.6%) of sphenoidal sinusitis, 3 cases (0.9%) of carotid artery lesion, 2 cases of meningitis (0.6%) and one case (0.3%) of each of the uncommon following complications: intrasella-suprasella hematoma, pontine hematoma and chiasmaplexy. Endocrinological complications occurred in 17.9% (54 cases): additional postoperative anterior lobe insufficiency in 35 cases (11.6%), and postoperative diabetes insipidus in 19 cases (6.3%). In our series, 3 cases of deaths (not directly related to the procedure) were also observed. Endoscopic transsphenoidal surgery represents an effective option for the treatment of patients with pituitary tumor. Complications still occur and must be reduced as much as possible. Successful endoscopic pituitary surgery requires extensive training in the use of an endoscope and careful planning of the surgery. Additional improvement can be expected with greater experience and new technical developments. |
| Databáze: | OpenAIRE |
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