Yasar UNSAL, Mustafa OZKAN, Ayca YILMAZ, Mehmet Ozgur OZATES
Journal of Comprehensive Surgery - 2026;4(1):5-9
Aims: To identify clinical, radiological, surgical, and postoperative factors associated with prolonged hospitalization following endoscopic transnasal/transsphenoidal pituitary surgery in a single tertiary neurosurgical center. Methods: This retrospective observational cohort study included 40 patients who underwent endoscopic transnasal/transsphenoidal pituitary surgery between January 2020 and December 2024. Demographic, clinical, radiological, surgical, and postoperative data were collected from electronic medical records. Length of hospital stay was analyzed as a continuous variable and dichotomized based on the cohort median to define prolonged hospitalization. Variables that were significant or near-significant in univariate analyses were included in multivariable logistic regression models to identify independent predictors of prolonged hospital stay. Results: A total of 40 patients were analyzed. Length of hospital stay did not follow a normal distribution, with a median length of stay of 8 days. In univariate analyses, suprasellar extension, postoperative cerebrospinal fluid leakage, and postoperative meningitis were significantly associated with prolonged hospital stay. Due to the strong clinical association between cerebrospinal fluid leakage and meningitis, these variables were not included together in the same multivariable model. After adjustment for Knosp grade, suprasellar extension remained an independent predictor of prolonged hospital stay (odds ratio: 11.1; 95% confidence interval: 1.03-119.5; p=0.04). Conclusion: Suprasellar extension is an independent determinant of prolonged hospital stay following endoscopic transnasal transsphenoidal pituitary surgery. Preoperative radiological assessment may assist in anticipating postoperative care requirements and optimizing perioperative management strategies.
