Outcomes of Endoscopic Endonasal Transsphenoidal Surgery of Pituitary Adenomas at the Philippine General Hospital
DOI:
https://doi.org/10.32412/pjohns.v41i1.2675Keywords:
Pituitary tumor, surgical outcomes, endoscopy, endonasal, transsphenoidal approach, PhilippinesAbstract
Objective: To review the surgical outcomes of patients who underwent endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas in our institution and compare them with the results of previous studies
Methods:
Design: Retrospective Review of Records
Setting: Tertiary National University Hospital
Participants: Records of 56 adult pituitary tumor patients who underwent EETS at the Philippine General Hospital in Manila, Philippines from January 2020 to December 2023 were retrospectively reviewed. Their age, sex, tumor size, presenting symptoms, resection rates, surgery duration and length of stay and complications were recorded. Multivariate linear regression analysis identified factors influencing rates of gross total resection (GTR), surgical
duration and hospital stay.
Results: GTR was achieved in 82% (n=46/56). The median surgery duration was 260 minutes (IQR 160-329 minutes), and the median hospital stay was 10 days (IQR 19.75-23.25 days). Complications arose in 35.7% (20/56), commonly diabetes insipidus (25%, 14/56) and meningitis (3.6%, 2/56)), but there were no mortalities (0%, 0/56 at 24 months follow-up). No factors were associated with GTR. Galactorrhea ((β = 1.769, 95% CI: 0.531-3.007, p=.010) and tumor size up to 6 cm (β = 0.572, 95% CI: 0.076-1.068, p=.032) were associated with more than 400 minutes operative time. Preoperative visual loss was associated with shorter admissions (-7.4 days, 95% CI: -11.994, -2.853, days, p=.004), while preoperative seizures (+19.4 days, , 95% CI: 6.447-32.327, p=.007), hypercortisolism (+10.9 days, 95% CI: 0.700-21.130, p=.040), and acromegaly (+7.1 days, 95% CI: 0.723-13.523, p=.037) were associated with longer stays. Each centimeter increase in tumor size predicted an increase in hospital stay by 1.1 days (95% CI: 0.071-2.169, p=.049).
Conclusion: EETS for pituitary adenomas in the Philippines led to high rates of GTR and manageable complication rates compared to previous studies. However, longer operative times and hospital stays were observed, which may reflect local practices, logistics, and demographics. Improved surgical infrastructure and experience may further optimize outcomes.
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