Postoperative Complications in Endoscopic Transnasal Transsphenoidal Pituitary Surgeries: A Retrospective Study

Objective: Although various techniques have been defined for the surgical resection of pituitary adenomas, the endoscopic transnasal transsphenoidal approach is preferred due to its wider surgical field of view and minimal invasiveness, resulting in lower complication rates. This study aimed to retrospectively analyze postoperative complications following endoscopic transnasal transsphenoidal pituitary surgery. Methods: Medical records of 2598 patients who underwent endoscopic transnasal transsphenoidal pituitary surgery between January 2018 and December 2024 were retrospectively reviewed. Data of age, gender, adenoma type, anesthesia management, and complications (and rates) were analyzed. Results: Of the patients, 53.2% (1381 patients) were female. The postoperative complication rate was 10.9% (338 patients), with the most common complications being cerebrospinal fluid (CSF) leak (4.4%), diabetes insipidus (3.3%), and epistaxis (2.6%). Apoplexy was most frequently observed in patients with non-secretory adenomas. Postoperatively, 48 patients (1.5%) required intensive care unit admission due to respiratory failure. The postoperative mortality rate was 0.4%. Conclusion: Endoscopic transnasal transsphenoidal surgery is a minimally invasive method for the treatment of pituitary adenomas. However, complications such as CSF leak, diabetes insipidus, and epistaxis may occur postoperatively. Establishing a multidisciplinary team is crucial to reduce complication risks and manage them effectively. Keywords: Transsphenoidal pituitary surgery, postoperative complications, pituitary adenomas, general anesthesia