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Immediate and delayed postoperative morbidity in functional and non-functioning pituitary adenomas

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Abstract

Neurosurgery is the most widely used definite treatment for pituitary tumors, while medical treatments are a good option to improve symptoms, which tend to recur when drugs are stopped. The aim of this study was to assess postsurgical morbidity of secreting pituitary adenomas (adrenocorticotropin hormone –ACTH- and growth hormone –GH- secreting) and non-functioning (NF) adenomas, operated between January 2002 and May 2009. We retrospectively reviewed the data of 94 patients who were operated by the same neurosurgeons and compared the immediate (1st month) and delayed (1st year) complications between the three groups of adenomas. Forty had immediate post-operative complications (42% of NF, 37% of GH-secreting and 48% of ACTH-secreting adenomas). The most frequent complications were transient diabetes insipidus (23%), cerebrospinal fluid leaks (7%), sinusitis and meningitis (2%). Patients with Cushing’s disease showed a tendency to have more transient diabetes insipidus and sinusitis compared to NF adenomas (P = 0.071). Ten patients had delayed complications during the first post-operative year (7% of NF, 11% of GH-secreting and 15% of ACTH-secreting), with a greater incidence of arthromyalgias and acute carpal tunnel syndrome in ACTH-secreting adenomas, compared with the other groups (P < 0.05). We conclude, that although ACTH-secreting adenomas are mostly microadenomas (78%) and affect younger patients, they are associated with a greater number of immediate and delayed complications during the first postoperative year (mainly invalidating arthromyalgias and acute carpal tunnel syndrome) compared with larger GH-secreting and NF adenomas, probably related to acute glucocorticoid deprivation after successful surgery.

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Authors and Affiliations

  1. Centro de Atención Especializada, CAP Roger de Flor, Dreta de l’Eixample Barcelona, Roger de Flor 194, 08013, Barcelona, Spain

    Anna Aulinas

  2. Endocrinology/Medicine Department, Consorci Sanitari Integral, Hospital Dos de Maig, Dos de Maig, 301, 08025, Barcelona, Spain

    Cristina Colom

  3. Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER Unit 747), Pare Claret 167, 08025, Barcelona, Spain

    Juan Ybarra

  4. Neurosurgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Pare Claret 167, 08025, Barcelona, Spain

    Fernando Muñoz & Pere Tresserras

  5. IIB-Sant Pau, Endocrinology/Medicine Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER Unit 747), Instituto de Salud Carlos III, Barcelona, and Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Pare Claret 167, 08025, Barcelona, Spain

    Eugenia Resmini & Susan M. Webb

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  1. Anna Aulinas
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  2. Cristina Colom
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  3. Juan Ybarra
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  4. Fernando Muñoz
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  5. Pere Tresserras
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  6. Eugenia Resmini
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  7. Susan M. Webb
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Correspondence to Anna Aulinas.

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Aulinas, A., Colom, C., Ybarra, J. et al. Immediate and delayed postoperative morbidity in functional and non-functioning pituitary adenomas. Pituitary 15, 380–385 (2012). https://doi.org/10.1007/s11102-011-0331-2

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  • DOI: https://doi.org/10.1007/s11102-011-0331-2

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