ENDONASAL ENDOSCOPIC TRANS-SPHENOIDAL SURGERY FOR PITUITARY ADENOMAS IN ALGERIA Single-Center Expertise and Evolution of Surgical Practices

Endonasal endoscopic trans-sphenoidal surgery, introduced in Algeria in 2003, has profoundly transformed the management of pituitary adenomas. We report a retrospective study including 224 patients operated on between 2014 and 2021 at the Department of Neurosurgery of Frantz Fanon University Hospital Center in Blida, aiming to evaluate the clinical outcomes and safety of this approach. 

Macroadenomas accounted for 79% of cases, and the endonasal endoscopic approach was used in 95% of procedures. No postoperative mortality was observed. The main complications were transient diabetes insipidus (9.2%), cerebrospinal fluid rhinorrhea (3.67%), meningitis (2.4%), and permanent hypopituitarism (0.57%).

These results confirm that endonasal endoscopic trans-sphenoidal surgery represents a safe and effective approach in the Algerian context. The experience of Frantz Fanon University Hospital Center in Blida illustrates the evolution and maturation of endoscopic pituitary surgery in Algeria, made possible through close multidisciplinary collaboration between neurosurgeons, endocrinologists, and radiologists. The sustainability of these results relies on continued training, maintenance of a structured multidisciplinary organization, and the development of prospective multicenter studies. 

Keywords: Pituitary adenomas; Endonasal endoscopic surgery; Trans-sphenoidal approach; Postoperative complications; Multidisciplinary collaboration; Algeria