Management and Methods of Avoidance of Complications in Endoscopic Endonasal Transsphenoidal surgery | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2024, Issue 7, July 2024 | ||||
| DOI: 10.58675/2682-339X.2575 | ||||
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| Authors | ||||
| Hamdy Behiry; Ahmed Ayad; Ahmed Abdrabo | ||||
| Neurosurgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: The concept of endoscopic endonasal transsphenoidal surgery for the removal of pituitary adenomas has evolved since Guiot attempted the first "endoscopic assisted" endonasal approach to the pituitary gland and had to abandon it because of poor visualization. Aim and objectives: To evaluate complications in endoscopic endonasal transsphenoidal surgery with methods of avoidance and management. Subjects and methods: This retrospective and prospective study was carried out on 121 patients who were operated on in the Neurosurgery Department at Al Azhar University Hospitals. Result: Of the 121 patients who were operated in the Neurosurgery Department at Al Azhar University Hospitals, 20 patients (16.5%) showed complications. From the total study group, there was an early postoperative Cerebrospinal Fluid (CSF) leak in 12 patients (10%) and a delayed postoperative CSF leak in 2 patients (1.2%). There was DI in 7 patients (5.8%), while there were no patients (0%) with Transient Hyponatremia or Hypernatremia and New permanent Pan- hypopituitarism in the studied patients. There was one patient (0.8%) with meningitis and three patients (2.4%) with sinusitis in the studied patients. There was epistaxis in 8 patients (6.6%), Pneumocephalus in 1 patient (0.8%), and intracranial hematoma in 7 patients (5.8%). Conclusion: Ten percent of patients had intra-operative CSF leaks, 3% had Internal Carotid Arteries (ICA) injury, 3% had venous injury, and 1.6% had cardiac complications. Postoperative CSF leaks were common in all patients, with early and delayed leaks in 10% and 1.2%, respectively. Postoperative endocrinal complications included DI in 5.8% of patients, meningitis in 0.8%, sinusitis in 2.4%, epistaxis in 6.6%, pneumocephalus in 0.8%, and intra-cranial hematoma in 5.8% of patients. | ||||
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