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Primary outcomes included 90-day complication rates, gland function outcomes, reoperations, readmissions and length of stay. Secondary outcomes were extent of resection, short-term endocrine remission, vision recovery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 514 patients, (mean age 51\u2009\u00b1\u200916\u00a0years; 78% macroadenomas, 19% prior surgery) major complications occurred in 18(3.5%) patients, most commonly CSF leak (9, 1.7%) and meningitis (4, 0.8%). In 14 of 18 patients, complications were deemed preventable. Four (0.8%) had complications with permanent sequelae (3 before 2016): one unexplained mortality, one stroke, one oculomotor nerve palsy, one oculoparesis. There were no internal carotid artery injuries, permanent visual worsening or permanent anosmia. New hypopituitarism occurred in 23\/485(4.7%). Partial or complete hypopituitarism resolution occurred in 102\/193(52.8%) patients. Median LOS was 2\u00a0days; 98.3% of patients were discharged home. Comparing 18 patients with major complications versus 496 without, median LOS was 7 versus 2\u00a0days, respectively p\u2009&lt;\u20090.001. Readmissions occurred in 6%(31\/535), mostly for hyponatremia (18\/31). Gross total resection was achieved in 214\/312(69%) endocrine-inactive adenomas; biochemical remission was achieved in 148\/209(71%) endocrine-active adenomas. Visual field or acuity defects improved in 126\/138(91.3%) patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study suggests that conformance to established protocols for endoscopic pituitary surgery may minimize complications, re-admissions and LOS while enhancing the likelihood of preserving gland function, although there remains opportunity for further improvements.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11102-021-01167-y","type":"journal-article","created":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T16:03:58Z","timestamp":1625241838000},"page":"930-942","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients"],"prefix":"10.1007","volume":"24","author":[{"given":"Jai Deep","family":"Thakur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Corlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regin Jay","family":"Mallari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Yawitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Eisenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walavan","family":"Sivakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chester","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo L.","family":"Carrau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Rettinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pejman","family":"Cohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Krauss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Araque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garni","family":"Barkhoudarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8358-056X","authenticated-orcid":false,"given":"Daniel F.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,2]]},"reference":[{"issue":"suppl_5","key":"1167_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/neuonc\/nox158","volume":"19","author":"QT Ostrom","year":"2017","unstructured":"Ostrom QT, Gittleman H, Liao P et al (2017) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010\u20132014. 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