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Complications of Transsphenoidal Surgery:Results of a National Survey, Review of the Literature, and Personal Experience
Neurosurg 40:225-236, Ciric,I.,et al, 1997
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Article Abstract
Of the respondents, 87.3% reported having performed <200 operations and 9.7% reported 200 to 500 previous operations. The remaining 3 % reported more than 500 previous operations. More extensive previous experience with transsphenoidal surgery was associated with a greater likelihood of having witnessed each specific complication. The mean operative mortality rate for all three groups was 0.9%. Anterior pituitary insufficiency (19.4%) and diabetes insipidus (17.8%) were complications with the highest incidence of occurrence. The overall incidence of cerebrospinal fluid fistulas was 3.9%. Other significant complications, such as carotid artery injuries, hypothalamic injuries, loss of vision, and meningitis, occurred with incidence ra tes between 1 and 2%. An inverse relationship was found between the experience group and the likelihood of complications, as indicated by significant negative Spearman correlation coefficients for all but 2 of the 14 complications listed in the survey (P <0.05). Thus, increased experience with transsphenoidal surgery seems to be associated with a decreased percentage of operations resulting in complications. Some caution should be exercised in interpreting these data.
 
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carotid artery injury
carotid artery laceration
cerebrospinal fluid,fistula
diabetes insipidus
hypothalamus,damage to
iatrogenic neurologic disorders
meningitis
meningitis,iatrogenic
microsurgery,transsphenoidal
neoplasm,pituitary
neoplasm,pituitary,treatment of
neurologic complications of,surgery
pituitary,adenoma
pituitary,insufficiency of
postoperative neurologic complications
visual loss

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