EARLY POSTOPERATIVE COMPLICATIONS OF ENDOSCOPIC ENDONASAL TRANS-SPHENOIDAL SURGERY IN PATIENTS WITH PITUITARY ADENOMA

Background: Endoscopic endonasal trans-sphenoidal surgery is widely used for the management of pituitary adenomas. While it offers several advantages over traditional approaches, early postoperative complications can affect patient outcomes and recovery. Objective: To determine the frequency of early postoperative complications following endoscopic endonasal transsphenoidal surgery in patients diagnosed with pituitary adenoma. Study Design: A descriptive study. Setting: The study was carried out in a tertiary care center equipped with endoscopic neurosurgical facilities (the Neurosurgery Department of Irfan General Hospital, Peshawar). Duration of Study: Postoperative outcomes were monitored for 30 days following surgery. Methods: Ninety-seven patients with pituitary adenomas confirmed on MRI underwent endoscopic endonasal transsphenoidal surgery. Early postoperative complications assessed within the 30-day postoperative period included hyponatremia (serum sodium <135 mEq/L), diabetes insipidus (characterized by polyuria with low urine specific gravity), hypopituitarism (specifically, growth hormone deficiency), and cerebrospinal fluid (CSF) leak, confirmed via beta-2 transferrin testing. Data were analyzed using descriptive statistics to report complication frequencies. Results: The mean age of patients was 41.03 ± 13.25 years, with a male predominance (55.7%). Among the 97 patients, early postoperative complications were as follows: diabetes insipidus in 10 patients (10.3%), hyponatremia in 8 patients (8.2%), hypopituitarism in 6 patients (6.2%), and CSF leak in 3 patients (3.1%). Conclusion: Endoscopic endonasal transsphenoidal surgery for pituitary adenoma is associated with manageable early postoperative complications. The most frequent were diabetes insipidus and hyponatremia, followed by hypopituitarism and CSF leak. Awareness and prompt management of these complications can improve patient recovery and surgical outcomes.