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Hormones

, Volume 17, Issue 4, pp 551–556 | Cite as

Transsphenoidal surgery for pituitary adenomas: early results from a single center

  • I. Karamouzis
  • M. Caputo
  • C. Mele
  • A. Nuzzo
  • M. Zavattaro
  • P. Car
  • G. Panzarasa
  • F. Prodam
  • P. Marzullo
  • Gianluca AimarettiEmail author
Original Article
  • 61 Downloads

Abstract

Objective

To evaluate early results of transsphenoidal surgery for pituitary adenomas.

Design

Retrospective evaluation of 90 consecutive patients undergoing endoscopic pituitary adenoma surgery (2007–2016) at “Maggiore della Carità” Hospital in Novara, Italy. Age at diagnosis, sex, symptoms at presentation, hormonal and radiological data, complications of surgery, and short-term follow-up information were collected.

Results

The majority of patients were male (M/F: 1.5/1, mean age at diagnosis 62.1 ± 1.5 years mean ± SEM). Most patients (91.1%) presented with a macroadenoma (27.4 mm ± 1.1 mm mean ± SEM), while 77.8% were non-functioning pituitary adenomas. Clinical presentations related to mass effect were visual impairment (74.0%) and/or hypopituitarism (55.1%). The main surgery complication was insipidus diabetes (12.2%), followed by cerebral hemorrhage (4.4%), cerebrospinal fluid (CSF) leaks (4.4%), syndrome of inappropriate antidiuresis (SIAD) (2.2%), and epistaxis (2.2%); only one patient died because of stroke. Risk of complications was not associated with tumor size (OR = 0.588, 95% CI 0.967–1.081, p = 0.443). Visual function improved in 70.6% of patients, while recovery of normal pituitary function occurred in 48.1%. Early neuroimaging studies demonstrated no residual tumor in 27.6% of patients. Invasion of cavernous sinus (OR = 3.293, 95% CI 0.897–16.738, p = 0.05) and maximum tumor diameter (OR = 6.857, 95% CI 1.039–1.309, p < 0.01) were associated with an unfavorable surgical outcome.

Conclusions

Transsphenoidal endoscopic surgery for pituitary adenomas is safe and is frequently followed by improvement in visual symptoms, whereas recovery of pituitary function is less common. In our patients, complete surgical removal of adenomas is comparable to that of other series, but further investigations will be necessary to clarify the long-term risk of tumor recurrence.

Keywords

Pituitary adenoma Transsphenoidal surgery Complications 

Notes

Compliance with ethical standards

The study protocol was approved by local ethics committee and written informed consent was obtained from all subjects.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Hellenic Endocrine Society 2018

Authors and Affiliations

  • I. Karamouzis
    • 1
  • M. Caputo
    • 1
  • C. Mele
    • 1
  • A. Nuzzo
    • 1
  • M. Zavattaro
    • 1
  • P. Car
    • 2
  • G. Panzarasa
    • 2
  • F. Prodam
    • 1
  • P. Marzullo
    • 1
  • Gianluca Aimaretti
    • 1
    Email author
  1. 1.Endocrinology, Department of Translational MedicineUniversità del Piemonte OrientaleNovaraItaly
  2. 2.NeurosurgeryAOU “Maggiore della Carità” HospitalNovaraItaly

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