Fully Endoscopic Transsphenoidal Surgery—Institutional Experience at a Single Center in Bogotá, Colombia

Introduction: Fully endoscopic endonasal surgery (fEES) has evolved to the point of becoming one of the preferred methods of treatment for many sellar region pathologies. The development of better technologies and improved results has led to the widespread adoption of these methods around the world. Although there is a learning curve associated with these types of procedures, they have proved to be extremely useful as part of the neurosurgical armamentarium. The purpose of this study was to retrospectively evaluate perioperative morbidity and mortality as measures of surgical outcomes in a single institution after the adoption of fEES.

Study Design: Retrospective review of a series of 142 cases of fEES performed at Hospital Universitario San Ignacio (Bogotá, Colombia) between the years 2008 and 2012.

Methods: Charts were obtained through the internal electronic records database of our institution. Every case was individually reviewed. Patients were excluded if they didn’t have complete postoperative 30-day follow-up.

Results: A total of 142 cases were included for analysis. Pituitary adenomas were the most frequent types of tumors (n = 122, 85.9%), followed by craniopharyngiomas (n = 6, 14.28%) and meningiomas (n = 5, 3.52%). Other cases included esthesioneuroblastoma (n = 1, 0.7%) and chordoma (n = 1, 0.7%). Approximate operative blood loss for all procedures was 400 cc. The mean length of stay was 9 days. The most commonly reported morbidity was transient diabetes insipidus (DI) (n = 18, 12.67%); only one patient developed permanent DI. Overall mortality was 2.8% (n = 4). Only one patient (n = 1, 0.7%) in the series required revision surgery for a persistent CSF leak.

Conclusions: fEES has proved to be an excellent form of surgical treatment of sellar pathologies. Its use has become widespread around the world. The current study shows the preliminary experience of a single university-affiliated hospital in Bogotá, Colombia, with comparable results to those reported previously in the literature.