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Pituitary

, Volume 18, Issue 6, pp 844–860 | Cite as

Surgery induced hypopituitarism in acromegalic patients: a systematic review and meta-analysis of the results

  • Pedro Carvalho
  • Eva Lau
  • Davide Carvalho
Article

Abstract

Purpose

Hypopituitarism is a possible complication of the surgical treatment of acromegaly. However, there is a wide variability in the incidence rates of surgery-induced hypopituitarism. The purpose of this study was the systematic collection and synthesis of information on the incidence rates of hypopituitarism, panhypopituitarism, specific axis deficiencies and diabetes insipidus after surgery for acromegaly treatment.

Methods

We systematically reviewed all the papers that have reported pituitary deficits after surgery for acromegaly published up until December 2014, in the PubMed database. We identified 92 studies enrolling 6988 patients. A meta-analysis was performed to evaluate the incidence rates. We also performed several subgroup analyses to evaluate the impact of both surgical technique, and treatment prior to surgery, on the results.

Results

The weighted incidence rates were 12.79 % for hypopituitarism (95 % CI 9.88–16.00 %), 2.50 % for panhypopituitarism (95 % CI 1.24–4.15 %), 6.50 % for ACTH deficiency (95 % CI 4.07–9.44 %), 4.39 % for TSH deficiency (95 % CI 2.99–6.04 %), 6.70 % for FSH/LH deficiency (95 % CI 3.89–10.17 %), 14.95 % for GH deficiency (95 % CI 7.25–24.64 %), 10.05 % for transient (95 % CI 7.18–13.33 %) and 2.42 % for permanent diabetes insipidus (95 % CI 1.70–3.27 %).

Conclusion

Our study provides new data on the incidence rates of hypopituitarism, specific pituitary axis deficiencies and diabetes insipidus after surgical treatment of acromegaly. Somatotroph function appears to be more prone to deficit than the other axes. However, there is a high heterogeneity between studies and several factors may influence the incidence of hypopituitarism.

Keywords

Acromegaly Hypopituitarism Diabetes insipidus Surgery Transsphenoidal 

Notes

Conflict of interest

The authors declare that they have no conflict of interest and no financial sponsoring.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Faculty of MedicineUniversity of PortoPortoPortugal
  2. 2.Department of Endocrinology, Diabetes and MetabolismCentro Hospitalar S. JoãoPortoPortugal
  3. 3.Instituto de Investigação e Inovação em SaúdeUniversidade do PortoPortoPortugal

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