Transsphenoidal hypophysectomy surgery

Abstract

Objective The aim of this study was to systematically collect data of patients undergoing transsphenoidal hypophysectomy and analyse with regard to clinical presentation, short and long term complications and demographic details. Methods This is a prospective study of transsphenoidal pituitary surgery at National Hospital Sri Lanka from May 2013 to August 2019. 108 patients who underwent transsphenoidal hypophysectomy for pituitary tumours were included. All the patients who underwent the procedure for the first time and for revision surgery were included in the study. Results Out of 108 patients, there were 87 primary cases and 21 revision cases. The average age at presentation was 45.39 years. The youngest patient was 2 years and 6 months old while the oldest was 76 years. 55 patients were male and 53 patients were female. The most common complaint at presentation was headache which affected 36 patients (33.3%). The visual disturbance was the second most common presentation, occurring in 32 individuals (29.6%). 103 patients out of 108 have been operated using trans-nasal transseptal approach and rest (5) by trans labial transseptal method.  The mean postoperative hospital stay was 9.8 days (range 3-17 days). The mean follow-up period was 35.7 months (range 3-75). 6 patients had died during the follow up period and 23 patients had defaulted follow up. Postoperative CSF leak occurred in 8 patients (7.4%) and anosmia was noted in 6 patients (5.5%). Conclusion Microscopic transsphenoidal pituitary is a safe and effective treatment for pituitary tumours, and the commonest complication is CSF leak. Anosmia is one of the complications of this procedure.