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Complication Rates after Endoscopic Transsphenoidal Surgery for ACTH-Secreting Pituitary Adenomas: A Comparative Analysis with GH and Nonfunctioning Adenomas
| Content Provider | Scilit |
|---|---|
| Author | Aibar-Durán, Juan Á. Oladotun-Anka, Michael Asencio-Cortés, Carlos Valassi, Elena Webb, Susan Gras-Cabrerizo, Juan R. Monserrat-Gili, Joan Ribó, Pere Tresserras Muñoz-Hernández, Fernando |
| Copyright Year | 2021 |
| Description | 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. |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1725029.pdf |
| Ending Page | e283 |
| Page Count | 10 |
| Starting Page | e274 |
| ISSN | 21936331 |
| DOI | 10.1055/s-0041-1725029 |
| Journal | Journal of Neurological Surgery Part B: Skull Base |
| Issue Number | S 02 |
| Volume Number | 83 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2021-03-02 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Neurological Surgery Part B: Skull Base Otorhinolaryngology Pituitary Adenoma Endoscopic Transsphenoidal Surgery Acth-secreting Adenomas |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) |
