Tasa de resección tumoral y complicaciones posoperatorias de la cirugía transesfenoidal en adenomas hipofisarios

Abstract

Pituitary adenomas (PA) are benign tumors arising from anterior pituitary cells and account for 8–15% of intracranial tumors. Surgery remains the primary treatment for most PA, particularly for non-functioning pituitary adenomas (NFPA). The aim of this study was to describe the outcomes of a consecutive series of patients undergoing pure endoscopic transsphenoidal surgery (ETSS) and to assess the efficacy and safety of this procedure. Materials and methods: We conducted a retrospective review of medical records from 2010 to 2022. Clinical, biochemical, and radiological data were collected preoperatively. The extent of tumor resection was classified as gross total resection (GTR), subtotal resection (STR), and partial resection (PR). Histopathological findings and perioperative complications were also recorded. Results: A total of 59 patients underwent ETSS for PA. NFPA represented most cases (57.1%), while growth hormone (GH)-secreting adenomas were the most common functioning subtype. GTR was achieved in 47 patients (79.7%) and PR in 9 (15.3%). Only 44.4% of giant adenomas (≥40 mm) were completely resected. Postoperative cerebrospinal fluid leak occurred in 3 patients (5.1%), and permanent diabetes insipidus in 2 patients (3.4%). No perioperative deaths were observed. Discussion: Endoscopic transsphenoidal surgery is a safe and effective treatment for PA, achieving satisfactory resection rates, favorable clinical outcomes, and low complication rates in this consecutive series.