Incidence of postoperative cerebrospinal fluid leaks in endoscopic endonasal transsphenoidal surgery for pituitary adenomas without sellar floor reconstruction: A retrospective observational study from a low-middle-income country
Abstract
Objectives: To determine the incidence of postoperative cerebrospinal fluid (CSF) leaks after endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas without sellar floor reconstruction (SFR).
Methods: This retrospective observational study was conducted at Department of Neurosurgery, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan from January, 2018 to December, 2022. It is a non-probability based consecutive case series. A total of 316 patients meeting the inclusion criteria were selected.
Results: Among the 316 patients, 102 (32.3%) were male, while 214 (67.7%) were female. Mean age was 40.98±7.8 SD (range 23 to 65 years). Regarding size of pituitary adenomas, 19 (6%) were microadenomas and 297 (94%) were macroadenomas. Overall postoperative CSF (poCSF) leak in our patients was 2.8%. Among cases with poCSF leak, 4 (3.9%) were male and five were female (2.3%) with the P-value of 0.477. Regarding size of pituitary adenomas, only one (5.3%) microadenoma had poCSF leak whereas 8 (2.7%) macroadenomas had poCSF leak with the P-value of 0.432.
Conclusion: Pituitary adenomas can be successfully treated with EETS without SFR in patients who do not experience intraoperative CSF leak.
List of Abbreviations: CSF: Cerebrospinal fluid, EETS: Endoscopic endonasal transsphenoidal surgery,
ioCSF: Intraoperative CSF, poCSF: Postoperative CSF, SFR: Sellar Floor Reconstruction,
T1WI: T1 weighted image, T1WI C+: T1 weighted image with contrast, T2WI: T2 weighted image.
doi: https://doi.org/10.12669/pjms.40.12(PINS).11109
How to cite this: Kiran S, Ikram S, Khizar A, Iftikhar MK, Qadri HM, Umer MW, et al. Incidence of postoperative cerebrospinal fluid leaks in endoscopic endonasal transsphenoidal surgery for pituitary adenomas without sellar floor reconstruction: A retrospective observational study from a low-middle-income country. Pak J Med Sci. 2024;40(12):S20-S24. doi: https://doi.org/10.12669/pjms.40.12(PINS).11109
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
