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

内镜经鼻蝶窦手术治疗垂体腺瘤(未行鞍底重建)术后脑脊液漏的发生率:一项来自中低收入国家的回顾性观察研究

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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.

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