A preferred treatment for residual/recurrent pituitary adenomas has not been established. The existence of higher complication rates for revision surgeries remains under debate. This study aimed to compare complication rates of primary and revision transsphenoidal endoscopic surgeries and to identify risk factors for complications. Data from 144 primary and 39 revision surgeries were analysed. The surgical complications evaluated were intraoperative and postoperative cerebrospinal fluid (CSF) leaks; meningitis; permanent diabetes insipidus (DI) and hypopituitarism; worsening visual acuity; ophthalmoplegias; visual field defects; otorhinolaryngological, systemic and vascular complications; and death. The variables that were potentially associated with surgical complications were gender, age, comorbidities, lumbar drain use, duration of lumbar drain use, invasion of the sphenoid and cavernous sinuses, presence and degree of suprasellar expansion, preoperative identification of the pituitary, CSF leaks and intraoperative pituitary identification. Intraoperative CSF leaks, visual field losses and worsening visual acuity were more common for revision surgeries. There were no between-group differences in the occurrence of postoperative CSF leaks; systemic, vascular and otorhinolaryngological complications; meningitis; DI and hypopituitarism; ophthalmoplegias; or death. Intraoperative identification of the pituitary was associated with lower rates of permanent DI and hypopituitarism, systemic complications, intraoperative CSF leaks and worsening visual acuity. Suprasellar expansion increased the risk of intraoperative CSF leaks but not endocrinological deficits or visual impairment. Intraoperative CSF leaks were associated with postoperative CSF leaks, meningitis, anterior hypopituitarism, DI and worsening visual acuity. Intraoperative CSF leaks, worsening visual acuity and visual field losses were more common in reoperated patients.

尚未确定残留/复发性垂体腺瘤的首选治疗方法。对于翻修手术而言，更高的并发症发生率仍然存在争议。这项研究旨在比较原发性和翻修经蝶窦内窥镜手术的并发症发生率，并确定并发症的危险因素。分析了来自144例主要手术和39例修订手术的数据。评估的手术并发症为术中和术后脑脊液（CSF）泄漏。脑膜炎; 永久性尿崩症（DI）和垂体功能低下；视力恶化；眼肌麻痹; 视野缺损；耳鼻喉科，全身和血管并发症；和死亡。与手术并发症潜在相关的变量包括性别，年龄，合并症，腰椎引流，腰椎引流的持续时间，蝶骨和海绵窦的侵袭，鞍上扩展的存在和程度，垂体的术前鉴别，CSF漏出和术中垂体鉴别。术中脑脊液渗漏，视野丧失和视力恶化在翻修手术中更为常见。术后脑脊液漏的发生没有组间差异。全身，血管和耳鼻喉科并发症；脑膜炎; DI和垂体功能低下; 眼肌麻痹; 或死亡。垂体的术中鉴定与永久性DI和垂体功能低下，系统并发症，术中CSF漏出和视力恶化有关。上鞍上扩张增加了术中脑脊液漏的风险，但没有增加内分泌缺陷或视力障碍。术中脑脊液漏与术后脑脊液漏，脑膜炎，前垂体功能低下，DI和视力恶化有关。再次手术患者更常见术中脑脊液漏，视力恶化和视野丧失。