Postoperative complications of pituitary tumor surgery

Written by Chen Yu Fei
Neurosurgery
Updated on August 31, 2024
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For patients with pituitary tumors, a range of complications, sequelae, or concomitant ailments can easily occur after surgery. For instance, postoperative sellar hematoma may occur, and some patients may even experience the rupture of a pseudoaneurysm. Additionally, some patients may repeatedly suffer from headaches, dizziness, nausea, vomiting, and weakness in the limbs after surgery, along with significant memory decline, reduced cognitive function—including calculating ability, and orientation in time, space, and person—gradually diminishing. These are considered postoperative sequelae of pituitary tumor surgery.

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Written by Chen Yu Fei
Neurosurgery
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How many days of hospitalization for pituitary tumor surgery?

For patients with pituitary tumors, it normally takes about one to two weeks to undergo surgery and be hospitalized. After surgery, it is appropriate for patients to rest in bed and refrain from getting up too early, mainly to monitor for any occurrence of cerebrospinal fluid rhinorrhea. Premature activity might lead to cerebrospinal fluid rhinorrhea or even trigger intracranial infections. Additionally, after surgery, it is important to perform blood tests to check the levels of endocrine hormones in the body, primarily to assess whether important electrolyte and hormone levels are normal. If there are abnormalities, adjustments should be made promptly, and discharge can be considered once the patient's condition is stable.

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Written by Chen Yu Fei
Neurosurgery
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What is a pituitary tumor?

Pituitary tumors refer to a type of benign tumor that occurs at the site of the pituitary fossa. Generally, they grow relatively slowly. In the early stages of the disease, there are usually no obvious symptoms or signs. Some patients may occasionally feel mild headaches or dizziness, which most can tolerate. As the size of the pituitary tumor gradually increases, it often affects the surrounding critical tissues, nerves, and organs, primarily impacting pituitary function, thereby leading to pituitary hypofunction. This affects the secretion of endocrine hormones in the body, causing abnormal secretion of endocrine hormones, and resulting in a series of symptoms and signs. For example, male patients may experience abnormalities in the secretion of male hormones, leading to difficulties with erection, while female patients are likely to experience menstrual disorders and irregular menstruation.

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Written by Chen Yu Fei
Neurosurgery
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Pituitary tumor complications

For patients with pituitary tumors, it is common to see certain complications, especially post-surgery, such as hematoma in the sellar region, life-threatening nasal hemorrhage, pseudoaneurysm rupture bleeding, cerebrospinal fluid rhinorrhea, meningitis, reduced pituitary function, diabetes insipidus, as well as associated issues with fluid, electrolyte imbalance, and acid-base imbalance. Some patients may also experience rare complications like eye muscle paralysis and nasal septum perforation. Therefore, for patients with pituitary tumors, it is crucial to closely monitor any changes in their condition after surgery. If any abnormalities are found, a prompt re-examination with a head CT should be conducted to observe changes and provide appropriate treatment.

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Written by Chen Yu Fei
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Can pituitary tumors heal on their own?

Under normal circumstances, pituitary tumors generally do not heal spontaneously. Pituitary tumors are benign tumors and although they grow slowly, they tend to continue growing. When they enlarge to a certain extent, they produce a series of symptoms and signs, such as headaches behind the eye sockets, the forehead, and both temporal sides. If the tumor breaks through the sellar diaphragm, it might also affect the optic nerve, leading to decreased vision and visual field defects. Moreover, it can severely erode the pituitary gland, causing symptoms and signs like decreased pituitary function, endocrine hormone disorders, and bringing significant suffering to the patient.

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Written by Chen Yu Fei
Neurosurgery
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How to treat pituitary tumors?

Currently, the treatment of pituitary tumors can generally be conducted through various methods such as surgery, medication, and radiation therapy. The specific choice of treatment for a patient depends on the patient's individual circumstances, including factors such as gender, age, the current size of the pituitary tumor, whether there is damage to other vital organs, and the patient's overall condition. For most symptomatic patients, surgery is usually recommended. Clinically, it is generally recommended to choose transnasal transsphenoidal surgery for complete removal, which often achieves very good therapeutic effects. However, for some pituitary tumors located in special positions where complete surgical removal is not achievable, radiation therapy or Gamma Knife surgery can be used in conjunction.