Retrospective Review of Surgical Site Infections after Endoscopic Endonasal Sellar and Parasellar Surgery: Multicenter Quality Data from the North American Skull Base Society

Saleh S., Sullivan S. E., Bellile E., Roxbury C., Das P., Hachem R. A., ...Daha Fazla

JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE, cilt.83, sa.06, ss.579-588, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 83 Sayı: 06
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1055/a-1865-3202
  • Dergi Adı: JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE
  • Sayfa Sayıları: ss.579-588
  • Anahtar Kelimeler: surgical site infections, pituitary adenomas, endonasal approach, antibiotics, PERIOPERATIVE ANTIBIOTICS, TRANSSPHENOIDAL SURGERY, PRACTICE PATTERNS, PROPHYLAXIS, PITUITARY
  • Gazi Üniversitesi Adresli: Evet

Özet

Introduction Transnasal access to the anterior skull base provides a minimally invasive approach for sellar and parasellar masses compared with its open counterparts. The unique microbiome of the sinonasal mucosa provides distinct challenges not encountered with other cranial approaches. The use of antibiotics in these cases has not been standardized, and data remain scarce regarding infectious outcomes. Methods We conducted a multicenter retrospective analysis of shared quality data points for the endoscopic endonasal approach (EEA) for pituitary adenomas, along with other sellar and parasellar region masses that were included by participating institutions. Patient and operative characteristics, perioperative and postoperative antibiotic regimens and their durations, intraoperative and postoperative cerebrospinal fluid leak, and onset of postoperative meningitis and sinusitis were compared. Results Fifteen institutions participated and provided 6 consecutive months' worth of case data. Five hundred ninety-three cases were included in the study, of which 564 were pituitary adenomectomies. The incidences of postoperative meningitis and sinusitis were low (0.67 and 2.87% for all pathologies, respectively; 0.35% meningitis for pituitary adenomas) and did not correlate with any specific antibiotic regimen. Immunocompromised status posed an increased odds of meningitis in pituitary adenomectomies (28.6, 95% confidence interval [1.72-474.4]). Conclusions The results show no clear benefit to postoperative antimicrobial use in EEA, with further larger studies needed.