Cerebrospinal fluid fistula after endoscopic transsphenoidal surgery: experience in a spanish center.
BACKGROUND
Postoperative cerebrospinal fluid (CSF) fistula is the most serious complication after transsphenoidal surgery.


OBJECTIVE
To analyze the incidence of CSF fistula after endoscopic transsphenoidal surgery for tumor removal in sellar region; to discuss associated factors and methods used for sellar closure.


METHODS
Retrospective study of 67 patients (73 surgeries) operated via transsphenoidal endoscopy at Hospital Vall D'Hebron and Hospital Clinic of the Universidad de Barcelona, Spain. The data collected included: age, sex, hospitalization stay, suprasellar extension of the lesion, type of tumor, evidence of intraoperative CSF fistula, complications of postoperative CSF fistula, previous surgery and radiotherapy.


RESULTS
Six patients (8.2%) had postoperative CSF fistula, and their average hospitalization was 5 days longer with resulting complications: two of whom had pneumoencephalus and two with meningitis. No association was found between the data collected and postoperative CSF fistula.


CONCLUSIONS
The rate of CSF fistula after endoscopic transsphenoidal surgery from the present study is contained within the literature. Unlike other reports, no association between the variables and postoperative CSF fistula was found in this report.
Romero
Alicia Del Carmen Becerra
Adel C
Department of Neurology of São Paulo Medical School, Division of Neurosurgery, Central Building, Hospital das Clínicas, São Paulo SP, Brazil. alicia21221@hotmail.com
Nora
Joaquim Enseñat
JE
Topczewski
Thomaz Eduardo
TE
Aguiar
Paulo Henrique Pires de
PH
Alobid
Isam
I
Rodriguéz
Enrique Ferrer
EF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D002648:Child; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects* / Q000379:methods; D010911:Pituitary Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D055815:Young Adult