Causes of Complications and Unplanned Early Readmissions in Endoscopic Pituitary Adenoma Surgery; Early Results of a Single-Center Study

INTRODUCTION: We aimed to reveal the complications, the early results of surgery and the reasons for early readmissions that may occur in a neurosurgery team that has just started endoscopic pituitary surgery.
METHODS: A retrospective analysis of patients with pituitary adenoma who were operated on in our clinic was performed. The patients were examined in terms of age, gender, and pathological diagnosis, whether there was a disorder in pre-operative hormone levels, post-operative complications, surgical and endocrine complications developed in the post-operative period, complaints, and findings during the planned and unplanned readmissions within the first 30 days.
RESULTS: Of the 23 patients included in the study, 13 were male and 10 were female. The ages of the patients ranged from 22 to 68 (mean 49.3). Intraoperatively cerebrospinal fluid leakage was observed during surgery in 4.3% of the patients, and sixth cranial nerve paralysis was observed in 4.3% of the patients as an additional surgical complication. As an endocrine disorder, diabetes insipidus developed in 13% of the patients in the post-operative period; however, the findings were temporary in 66.6% of these patients. In the first routine follow-up examination after discharge, no complaints were observed in 82.6% of the patients, anosmia was observed in 4.3%, cacosmia in 4.3%, and runny nose in 4.3% of patients. Unrelated to the routine control examination, 26% of the patients admitted to the hospital unplanned in the first 30 days postoperatively, and the complaints were neck pain, rhinorrhea, headache, nausea-vomiting, double vision, and epistaxis.
DISCUSSION AND CONCLUSION: The results of this study showed that during the follow-up period, neurosurgeons should pay emphasis to transient diabetes insipidus, rhinorrhea, hormonal failure, and sixth cranial nerve paralysis. Complication rates in clinics new to the procedure are similar to the existing literature due to the widespread use of endoscopic pituitary surgery, the ease of learning the surgical procedure, and the fact that challenging cases are not selected in the first stage of surgery.