Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas.
OBJECTIVE
To assess postoperative complications related to the surgical procedure, a retrospective analysis was conducted in a series of 146 consecutively treated patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of pituitary adenomas between January 1997 and July 2001.


METHODS
Complications were divided into groups (nasofacial, sphenoid sinus, sella turcica, supra or parasellar, and endocrine complications) according to the anatomical structures and the systems involved. Overall, a decreased incidence of complications has been observed, compared with large historical series of the traditional microsurgical transsphenoidal approach, likely because of the overview inside the anatomy facilitated by the endoscope, and the decreased surgical trauma.


CONCLUSIONS
Transsphenoidal surgery, either microscopic or endoscopic, is a safe procedure in experienced hands, but serious complications still occur and must be reduced as much as possible. Additional improvement can be expected with greater experience and new technical developments. A coordinated team effort with other dedicated colleagues from different specialties is advised.
Department of Neurological Sciences, Federico II University, Naples, Italy. cappabia@unina.it
Paolo
P
Cappabianca
Luigi Maria
LM
Cavallo
AnnaMaria
A
Colao
Enrico
E
de Divitiis
D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012658:Sella Turcica / Q000601:surgery; D012720:Severity of Illness Index; D013101:Sphenoid Sinus / Q000601:surgery*