Analysis Complication And Its Relative Risk Factors After Endoscopic Resection Of Pituitary Adenoma

ObjectiveBy investigating complications after pituitary adenoma resection through endoscopic endonasal transsphenoidal approach,we summarized the relative risk factors so as to help in the improvement of clinical outcome.MethodsThe clinical data and postoperative complications of 114 patients with pituitary adenoma were collected.All of them had accepted microsurgical tumor resection through endoscopic endonasal transsphenoidal approach at The Second Affiliated Hospital of College of Medicine,Zhejiang University from January 1,2016 to December 31,2016.Variables analyzed including patients’ age,sex,body mass index,history of hypertension,diabetes mellitus,smoking and drinking,preoperative visual impairment,preoperative endocrinal disorders,tumor size,operation time,reoperation,intraoperative blood loss and intraoperative CSF leak.Univariate chi-square analysis and Logistic regression were performed to detect possible risk factors.ResultsA total of 114 cases were included in this study.We found that 70 cases suffered from post-operative complications(61.4%),among them cerebrospinal rhinorrhea in 10 cases(8.8%),intracranial infection in 5 cases(4.4%),hyponatremia in 29 cases(25.4%),hypopituitarism in 16 cases(14.0%),diabetes insipidus in 46 cases(40.4%),rhinorrhagia in 4 cases(3.5%),cerebral infarction in 1 case(0.9%)and pneumonia in 1 case(0.9%).Univariate analysis showed revealed no relative risk factors for postoperative complications after endoscopic resection of pituitary tumors.However,subgroup univariate analysis showed that patients’ smoking and drinking history were potential risk factors for intracranial infection,long operation time(≥3h)was a potential risk factor for both CSF rhinorrhea and diabetes insipidus,in addition,old age(≥55 y)was also a potential risk factor for diabetes insipidus.Logistic regression demonstrated that patients’ long operation time(≥3h)was an independent risk factor for postoperative diabetes insipidus.ConclusionIntracranial infection,hyponatremia,epistaxis,hypopituitarism,cerebrospinal fluid rhinorrhea,diabetes insipidus and rhinorrhagia are common complications of endoscopic resection of pituitary adenomas.long operation time(≥3h)is a risk factor for postoperative diabetes insipidus.