Logo image
Back
Complications following primary and revision transsphenoidal surgeries for pituitary tumors
Journal article   Open access   Peer reviewed

Complications following primary and revision transsphenoidal surgeries for pituitary tumors

James G Krings, Dorina Kallogjeri, Andre Wineland, Kenneth G Nepple, Jay F Piccirillo and Anne E Getz
The Laryngoscope, Vol.125(2), pp.311-317
02/2015
DOI: 10.1002/lary.24892
PMCID: PMC4305002
PMID: 25263939
url
https://doi.org/10.1002/lary.24892View
Published (Version of record) Open Access

Abstract

Objectives/Hypothesis This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications, respiratory failure, and death. Secondarily, this study aimed to examine factors associated with the occurrence of complications. Study Design Retrospective cohort analysis of California and Florida all‐payer databases from 2005 to 2008. Methods The major complication rate following both primary and revision transsphenoidal pituitary surgery was calculated. Bivariate analyses were performed to investigate the relationship of patient characteristics with complication occurrence, and a multivariate model was constructed to determine risk factors associated with these complications. Results There were 5,277 primary cases and 192 revision cases that met inclusion criteria. There was a nonsignificant absolute difference of 3.09% (95% confidence interval [CI]: −11.00 to 16.14) between the rate of complications following primary (n = 443, 8.39%) and revision (n = 22, 11.46%) surgeries. Multivariate analyses showed that patients with Medicare (odds ratio [OR]:1.74, 95% CI: 1.17 to 2.61), Medicaid (OR: 2.13, 95% CI: 1.59 to 2.86), or a malignant neoplasm (OR: 3.10, 95% CI: 1.62 to 5.93) were more likely to have complications. Conclusions The rate of major complications following transsphenoidal pituitary surgery is lower than earlier retrospective reports. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications. Level of Evidence 2C Laryngoscope, 125:311–317, 2015
 cerebrospinal fluid leak diplopia complications panhypopituitarism Transsphenoidal surgery diabetes insipidus pituitary adenomas vision loss orbital hematoma hemorrhage

Details

Metrics

18 Record Views
27 Times Cited - Web of Science
Logo image