Endocrine Abstracts

Object: The aim of the study was to evaluate the safety and efficacy of the pure endoscopic removal of the pituitary adenomas with special references to the complications.

Material and methods: The authors analyzed retrospectively a database of 52 consecutive patients (16 males and 36 females) with pituitary adenomas who underwent endoscopic transsphenoidal surgery. Preoperative examination was based on radiological visualization of the tumor and endocrinological evaluation. The extend of the resection was gauged on postoperative contrast-enhanced 1.5 T MR imaging. Endocrinological remission was defined as normalization of the pituitary function (acromegaly: basal serum GH level <1 ng/ml and a nadir GH level <0.4 ng/ml after oral glucose load, Cushing’s disease: early morning cortisol level <2 ug/dl, PRL-oma: serum PRL level <20 ng/ml).

Results: There were 15 patients with NFPA, 24 patients with GH-secreting pituitary adenoma, seven patients with ACTH-secreting pituitary adenoma and five patients with PRL-secreting pituitary adenoma. The majority of patients had macroadenomas. Remission rate was 69%. A retrospective analysis of complications was conducted. There were no fatal complications and permanent morbidity was 7.7% (one permanent diabetes insipidus and three pituitary insufficiency). Other surgical complications included one syndrome of inappropriate secretion of antidiuretic hormone, one epistaxix and one sinusitis. There were no medical compications.

Conclusions: Endoscopic transsphenoidal removal of pituitary adenoma is safe and effective method. It leads to a high rate of tumor resection and endocrionological remission. A number of surgical complications is low and comparable to those found in patients undergoing microsurgical transsphenoidal operation.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.