A large retrospective series evaluating perioperative complications, readmission and reoperation after endoscopic transsphenoidal surgery for pituitary adenomas.

Pham, Cote, Kang, Carmichael, Zada and colleagues analyzed 709 procedures in 693 patients.

Gross-total resection was achieved in 63.5%. Postoperative CSF leak occurred in 4.2%, transient diabetes insipidus in 8.7% and permanent diabetes insipidus in 2.4%. Early readmission occurred in 10.2% and early reoperation in 4.8%. Delayed hyponatremia was the most common cause of readmission.

Larger tumor size, firm consistency, intraoperative CSF leak and extended approaches were associated with higher complication risk.

Why it matters

This study provides useful contemporary benchmarks for quality assessment, perioperative counseling and postoperative endocrine surveillance after endoscopic pituitary surgery. It also highlights delayed hyponatremia as a major preventable driver of readmission.

Reference

Pham J, Cote DJ, Kang KM, Carmichael JD, Zada G, et al.
Incidence and predictors of complications, readmission, and reoperation following endoscopic transsphenoidal surgery for pituitary adenomas.
Journal of Neurosurgery. 2026;145(4):1035-1047. Published online July 24, 2026.
DOI: 10.3171/2026.2.JNS252393
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