{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:02:48Z","timestamp":1785884568461,"version":"3.56.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Delayed epistaxis after endoscopic transnasal pituitary tumor resection (ETPTR) is a critical complication, tending to cause aspiration or hemorrhagic shock. This study assessed clinical characteristics, risk factors, and provide treatment and prevention advice of this complication.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a retrospective monocentric analysis of 862 patients who underwent ETPTR. Statistical analyses of clinical data revealed the incidence, sources and onset time of delayed epistaxis. Univariate analysis and binary logistic regression were used to identify risk factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The incidence of delayed epistaxis was 2.78% (24\/862), with an average onset time of 20.71\u2009\u00b1\u20097.39 days. The bleeding sources were: posterior nasal septal artery branch of sphenopalatine artery (12\/24), multiple inflammatory mucosae (8\/24), sphenopalatine artery trunk (3\/24) and sphenoid sinus bone (1\/24). Univariate analysis and binary logistic regression analysis confirmed that hypertension, nasal septum deviation, chronic rhinosinusitis and growth hormone pituitary tumor subtype were independent risk factors for delayed epistaxis. Sex, age, history of diabetes, tumor size, tumor invasion and operation time were not associated with delayed epistaxis. All patients with delayed epistaxis were successfully managed through endoscopic transnasal hemostasis without recurrence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Delayed epistaxis after ETPTR tends to have specific onset periods and risk factors. Prevention of these characteristics may reduce the occurrence of delayed epistaxis. Endoscopic transnasal hemostasis is recommended as the preferred treatment for delayed epistaxis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-024-03428-z","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T01:05:41Z","timestamp":1717203941000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Delayed epistaxis after endoscopic transnasal pituitary tumor resection: clinical characteristics, risk factors, treatment and prevention"],"prefix":"10.1186","volume":"22","author":[{"given":"Chengzhi","family":"Mu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengyuan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"issue":"3","key":"3428_CR1","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1093\/neuros\/nyz201","volume":"86","author":"AM Casta\u00f1o-Leon","year":"2020","unstructured":"Casta\u00f1o-Leon AM, Paredes I, Munarriz PM, et al. Endoscopic Transnasal Trans-Sphenoidal Approach for Pituitary adenomas: a comparison to the Microscopic Approach Cohort by Propensity Score Analysis.[J]. Neurosurgery. 2020;86(3):348\u201356.","journal-title":"Neurosurgery"},{"issue":"5","key":"3428_CR2","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00701-007-1134-0","volume":"149","author":"H Nishioka","year":"2007","unstructured":"Nishioka H, Ohno S, Ikeda Y, et al. Delayed massive epistaxis following endonasal transsphenoidal surgery[J]. Acta Neurochir (Wien). 2007;149(5):523\u20136.","journal-title":"Acta Neurochir (Wien)"},{"issue":"1","key":"3428_CR3","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jocn.2014.07.004","volume":"22","author":"RK De Los","year":"2015","unstructured":"De Los RK, Gross BA, Frerichs KU, et al. Incidence, risk factors and management of severe post-transsphenoidal epistaxis[J]. J Clin Neurosci. 2015;22(1):116\u201322.","journal-title":"J Clin Neurosci"},{"issue":"8","key":"3428_CR4","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1002\/alr.22345","volume":"9","author":"J Kam","year":"2019","unstructured":"Kam J, Ahmad A, Williams A, et al. Postoperative epistaxis and sphenoid sinus ostial stenosis after posterior septal branch injury during sphenoidotomy[J]. Int Forum Allergy Rhinology. 2019;9(8):842\u20139.","journal-title":"Int Forum Allergy Rhinology"},{"issue":"3","key":"3428_CR5","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1177\/0194599812443042","volume":"147","author":"RB Rawal","year":"2012","unstructured":"Rawal RB, Kimple AJ, Dugar DR, et al. Minimizing morbidity in endoscopic pituitary surgery: outcomes of the novel nasoseptal rescue flap technique[J]. Otolaryngol Head Neck Surg. 2012;147(3):434\u20137.","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"6","key":"3428_CR6","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1159\/000345500","volume":"74","author":"CF Thompson","year":"2012","unstructured":"Thompson CF, Wang MB, Kim BJ, et al. Incidence and management of epistaxis after endoscopic skull base surgery[J]. ORL J Otorhinolaryngol Relat Spec. 2012;74(6):315\u20139.","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"issue":"12","key":"3428_CR7","doi-asserted-by":"publisher","first-page":"2684","DOI":"10.1002\/lary.21446","volume":"121","author":"JA Stankiewicz","year":"2011","unstructured":"Stankiewicz JA, Lal D, Connor M, et al. Complications in endoscopic sinus surgery for chronic rhinosinusitis: a 25-year experience[J]. Laryngoscope. 2011;121(12):2684\u2013701.","journal-title":"Laryngoscope"},{"issue":"5","key":"3428_CR8","first-page":"302","volume":"34","author":"G Xu","year":"1999","unstructured":"Xu G, Li Y, Xie M. [Staging of mucous membrane outcome in operative cavity after functional endoscopic sinus surgery][J]. Zhonghua Er Bi Yan Hou Ke Za Zhi. 1999;34(5):302\u20135.","journal-title":"Zhonghua Er Bi Yan Hou Ke Za Zhi"},{"issue":"2","key":"3428_CR9","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1159\/000114535","volume":"70","author":"G Xu","year":"2008","unstructured":"Xu G, Jiang H, Li H, et al. Stages of nasal mucosal transitional course after functional endoscopic sinus surgery and their clinical indications[J]. ORL J Otorhinolaryngol Relat Spec. 2008;70(2):118\u201323.","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"issue":"4","key":"3428_CR10","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.8.FOCUS10156","volume":"29","author":"G Zada","year":"2010","unstructured":"Zada G, Cavallo LM, Esposito F, et al. Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations[J]. Neurosurg Focus. 2010;29(4):E8.","journal-title":"Neurosurg Focus"},{"issue":"2","key":"3428_CR11","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s00405-013-2450-z","volume":"271","author":"D Kikidis","year":"2014","unstructured":"Kikidis D, Tsioufis K, Papanikolaou V, et al. Is epistaxis associated with arterial hypertension? A systematic review of the literature[J]. Eur Arch Otorhinolaryngol. 2014;271(2):237\u201343.","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"1","key":"3428_CR12","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jcma.2010.09.001","volume":"74","author":"YP Wang","year":"2011","unstructured":"Wang YP, Wang MC, Chen YC, et al. The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery[J]. J Chin Med Assoc. 2011;74(1):16\u201321.","journal-title":"J Chin Med Assoc"},{"key":"3428_CR13","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.wneu.2017.09.192","volume":"109","author":"G Alzhrani","year":"2018","unstructured":"Alzhrani G, Sivakumar W, Park MS, et al. Delayed complications after Transsphenoidal surgery for pituitary Adenomas[J]. World Neurosurg. 2018;109:233\u201341.","journal-title":"World Neurosurg"},{"issue":"5","key":"3428_CR14","doi-asserted-by":"publisher","first-page":"365","DOI":"10.7326\/0003-4819-154-5-201103010-00011","volume":"154","author":"J Mullol","year":"2011","unstructured":"Mullol J, Alobid I. Combined oral and intranasal corticosteroid therapy: an advance in the management of nasal polyposis?[J]. Ann Intern Med. 2011;154(5):365\u20137.","journal-title":"Ann Intern Med"},{"key":"3428_CR15","doi-asserted-by":"crossref","unstructured":"Favier V, Le Corre M, Segnarbieux F, et al. Endoscopic subperichondrial transseptal transsphenoidal approach is safe and efficient for non-extended pituitary surgery[J]. Volume 277. European Archives of Oto-Rhino-Laryngology; 2020. pp. 1079\u201387. 4.","DOI":"10.1007\/s00405-020-05790-6"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03428-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-024-03428-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03428-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T01:05:57Z","timestamp":1717203957000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-024-03428-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3428"],"URL":"https:\/\/doi.org\/10.1186\/s12957-024-03428-z","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,1]]},"assertion":[{"value":"12 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by ethics committee of Shandong provincial hospital affiliated to Shandong first medical university (SZRJJ: NO.2021).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All patients provided written informed consent to participate in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"146"}}