Fístulas posquirúrgicas de líquido cefalorraquídeo tras cirugía transesfenoidal de adenomas hipofisarios: análisis de una serie de 302 intervenciones |
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| Institution: | 1. Servicio de Neurocirugía, Hospital Universitario de la Ribera, Alzira, Valencia, España;2. Unidad Docente Multidisciplinar de Atención Familiar y Comunitaria, Castellón, España;3. Servicio de Otorrinolaringología, Hospital Universitario de la Ribera, Alzira, Valencia, España;4. Servicio de Medicina Interna, Hospital Universitario de la Ribera, Alzira, Valencia, España;5. Servicio de Endocrinología, Hospital Universitario de la Ribera, Alzira, Valencia, España;6. Facultad de Medicina, Universidad Católica de Valencia «San Vicente Mártir», Valencia, España;7. Cátedra de Neurociencias, CEU Universidad Cardenal Herrera / Fundación Vithas-NISA Valencia, Valencia, España;1. Department of Neurosurgery, Apex Cerrahi Tıp Merkezi, İstanbul, Turkey;2. Department of Neurosurgery, Harran Üniversity, Şanlıurfa, Turkey;1. Liv Hospital, Ankara, Turkey;2. Dr. Abdurrahman Yurtaslanı Onkoloji Hastanesi, Ankara, Turkey;3. Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Ankara, Turkey;4. Ufuk Üniversitesi Tıp Fakültesi Dr. Rıdvan Ege Hastanesi, Ankara, Turkey;1. Departamento de Neurocirugía, Hospital Central Sur de Alta Especialidad de PEMEX, Ciudad de México, México;2. Departamento de Anestesiología, Hospital Central Sur de Alta Especialidad de PEMEX, Ciudad de México, México;1. Department of Neurosurgery, University of Tokyo Hospital, Tokyo, Japan;2. Department of Otorhinolaryngology, University of Tokyo Hospital, Tokyo, Japan |
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| Abstract: | IntroductionTranssphenoidal surgical removal is the preferred treatment of most pituitary adenomas. Postoperative cerebrospinal fluid (CSF) leakage is the leading cause of morbidity after this procedure, with an incidence rate that varies from 0,5-15% in the main published series.ObjectivesThe primary objective of this study was to establish the incidence of postoperative CSF leakage in a sample of surgeries performed at the University Hospital of La Ribera by the same surgical team. The secondary objectives were to: ascertain the distinctive features between patients with and without postoperative CSF leakage, identify risk factors for their development, evaluate the relationship between the surgical technique for closing the sella turcica and the onset of postoperative CSF leakage and evaluate different treatment regimens for this complication.MethodsThe data of 302 consecutive transsphenoidal surgical procedures for pituitary adenoma removal which were performed between 1999 and 2017 were retrospectively reviewed.Results and conclusionsThe incidence of postoperative CSF leakage in our series was 2,3% (in accordance with similar published studies). It was possible to correlate intraoperative CSF leakage with two variables: pituitary macroadenoma and tumors with suprasellar extension (P < .005). This correlation did not exist for postoperative CSF leakage. We found a statistically significant correlation between intraoperative and postoperative CSF leakage (P < .005). Due to the low incidence of postoperative CSF leakage in our series, it was not possible to identify risk factors for its development. |
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| Keywords: | Postoperative CSF leak Transsphenoidal surgery Pituitary adenoma Surgical complications |
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