{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:24:42Z","timestamp":1784291082205,"version":"3.55.0"},"reference-count":87,"publisher":"Georg Thieme Verlag KG","issue":"S 02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Cerebrospinal fluid (CSF) leak is widely recognized as a challenging and commonly occurring postoperative complication of transsphenoidal surgery (TSS).<\/jats:p><jats:p>The primary objective of this study is to benchmark the current prevalence of CSF leak after TSS in the adult population.<\/jats:p><jats:p>\n          Methods\u2003The authors followed the PRISMA guidelines. The PubMed, Embase, and Cochrane Library databases were searched for articles reporting CSF leak after TSS in the adult population. Meta-analysis was performed using the Untransformed Proportion metric in OpenMetaAnalyst. For two between-group comparisons a generalized linear mixed model was applied.<\/jats:p><jats:p>\n          Results\u2003We identified 2,408 articles through the database search, of which 70, published since 2015, were included in this systematic review. These studies yielded 24,979 patients who underwent a total of 25,034 transsphenoidal surgeries. The overall prevalence of postoperative CSF leak was 3.4% (95% confidence interval or CI 2.8\u20134.0%). The prevalence of CSF leak found in patients undergoing pituitary adenoma resection was 3.2% (95% CI 2.5\u20134.2%), whereas patients who underwent TSS for another indication had a CSF leak prevalence rate of 7.1% (95% CI 3.0\u201315.7%) (odds ratio [OR] 2.3, 95% CI 0.9\u20135.7). Patients with cavernous sinus invasion (OR 3.0, 95% CI 1.1\u20138.7) and intraoperative CSF leak (OR 5.9, 95% CI 3.8\u20139.0) have increased risk of postoperative CSF leak. Previous TSS and microscopic surgery are not significantly associated with postoperative CSF leak.<\/jats:p><jats:p>\n          Conclusion\u2003The overall recent prevalence of CSF leak after TSS in adults is 3.4%. Intraoperative CSF leak and cavernous sinus invasion appear to be significant risk factors for postoperative CSF leak.<\/jats:p>","DOI":"10.1055\/s-0041-1733918","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T22:49:12Z","timestamp":1629499752000},"page":"e501-e513","source":"Crossref","is-referenced-by-count":26,"special_numbering":"S","title":["Cerebrospinal Fluid Leak after Transsphenoidal Surgery: A Systematic Review and Meta-analysis"],"prefix":"10.1055","volume":"83","author":[{"given":"Emma M.H.","family":"Slot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rengin","family":"Sabaoglu","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard H.J.","family":"Voormolen","sequence":"additional","affiliation":[{"name":"Department of 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