The Use of Intraoperative Lumbar Drain and Local Flaps/Grafts in Pituitary Adenoma Surgery: A 5-Year Institutional Experience.

This article discusses the use of various techniques to reduce the occurrence of cerebrospinal fluid (CSF) leaks after pituitary surgery. The study examines the experience of a single institution over a five-year period, focusing on the use of intraoperative lumbar drains and repair techniques. The results show that the lumbar drain was used in all cases, with post-operative use in 24.2% of patients. CSF leaks were encountered intraoperatively in 28.8% of cases and postoperatively in only 4.5% of cases. Different repair techniques, such as naso-septal flaps and surgical sealants, were used depending on the size of the defect. The study also found that certain patient characteristics, such as a pre-op diagnosis of CAD and/or dyslipidemia, were associated with a higher rate of intraoperative CSF leak. The use of navigation during surgery did not significantly affect the risk of CSF leak. The article concludes that simple closure with a single sealant layer or a graft or flap is appropriate in cases with limited resources, and that patient comorbidities and intraoperative flow rate should be considered when deciding on a reconstruction technique. [Extracted from the article]