Boling et al identified risk factors associated with perioperative complications in patients undergoing transnasal endoscopic resection of a pituitary adenoma. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in the United States, Canada and Australia.


Patient selection: transnasal endoscopic resection of a pituitary adenoma


Outcome: perioprative complication (one or more occurred in 24% of patients)

Risk Factor

Associated Complication

extrapituitary extension

deep vein thrombosis, cardiac, cranial nerve damage

intraventricular extension

systemic, intracranial, reoperation, postoperative CSF leak

extension into anterior fossa

intracranial bleed

age of the patient <= 64 years of age

reoperation, postoperative CSF leak, readmission

female gender

postoperative CSF leak

body mass index >= 30 kg per sq m

postoperative CSF leak

previous radiation

pneumocephalus, internal carotid artery injury, other intracranial

liver disease



Systemic complications included deep vein thrombosis, respiratory complications including pneumonia, and cardiac complications.


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