Abstract

Introduction: Pituitary adenomas are the most common tumors of the sellar region and may cause endocrine dysfunction as well as neurological symptoms due to mass effect. Surgical treatment remains the mainstay of management for these lesions, particularly with the widespread adoption of the endoscopic transsphenoidal approach. The aim of this study was to evaluate the clinical, pathological, and postoperative outcomes of endoscopic transsphenoidal surgery in a large cohort of patients surgically treated for pituitary lesions between 2018 and 2025, and to compare the complication profile with data reported in the literature.

Methods: A total of 204 patients who underwent surgical treatment for pituitary lesions between 2018 and 2025 were included in the study. All cases were evaluated retrospectively. Demographic data, pathological diagnoses, surgical approaches, and postoperative complications were analyzed. Statistical analyses were performed using the latest version of SPSS software.

Results: The mean age of the patients was 47.3 ± 13.9 years; 58.8% were female and 41.2% were male. Pathological evaluation revealed that the most frequent diagnosis was Cushing’s disease (20.1%), followed by non-functioning pituitary adenomas (19.6%), FSH–LH secreting adenomas (16.7%), and acromegaly (14.2%). In the postoperative period, transient diabetes insipidus developed in 70 patients (34.3%), while permanent desmopressin requirement was observed in 4 patients (5.7%). Cerebrospinal fluid rhinorrhea occurred in 30 patients (14.7%); 22 of these patients underwent reoperation due to cerebrospinal fluid fistula. Among the 10 patients with residual adenoma, 4 underwent additional endoscopic surgery and 6 underwent transcranial surgery. Postoperative hematoma was observed in 8 patients (3.9%), epistaxis in 4 patients (2%), meningitis in 5 patients (2.4%), and hydrocephalus in 2 patients (1%). Mortality occurred in 1 patient (0.5%).

Conclusions: Endoscopic transsphenoidal surgery is a safe and effective treatment modality for pituitary lesions, with low mortality and acceptable complication rates. Although additional surgical approaches may be required in selected cases, satisfactory clinical outcomes can be achieved when the procedure is performed in experienced centers.

Keywords: pituitary adenoma, endoscopic transsphenoidal surgery, postoperative complications

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Copyright © 2025 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Can H, Örnek V, Öztürk S. A retrospective analysis of complications following endoscopic transsphenoidal pituitary surgery. Sinir Sistemi Cerrahisi Derg 2025;10(3):111-119. https://doi.org/10.54306/SSCD.2025.232