Endocrine Abstracts

Introduction: Pituitary surgery is associated with post-operative complications including hypopituitarism and visual field defects. In order to ensure that our surgical outcomes were comparable with other centres, we audited the outcome of a cohort of patients referred for surgery at a single centre.

Methods: A retrospective audit of 27 consecutive patients diagnosed with pituitary adenoma at Heartlands Hospital Birmingham, who underwent trans-sphenoidal surgery pituitary. Surgery was performed by a single neurosurgeon at our primary referral centre (University Hospital Coventry). Clinical notes and electronic records were used for auditing clinical outcomes. Between-group comparisons were made with T-test and ANOVA.

Results: Twenty-seven patients (12 males, 15 females; median age 61 years, age range 25–82 years) underwent surgery during the audit period. Main diagnoses were non-functioning pituitary adenoma (63%), acromegaly (22%) and Cushing’s disease (4%); 85% (n=23) had a macroadenoma. Before surgery, 21 patients (78%) did not have any hormonal deficiencies, 18 patients (67%) had normal visual fields. Post-operatively, ten patients (37%) developed a new anterior hormonal deficiency (one axis affected, two patients; two axes, two patients; three axes, four patients); four patients (15%) developed new diabetes insipidus. In the macroadenoma group, 48% maintained full pituitary function post-operatively. Only one patient, operated on a recurrence of a previous non-functioning macroadenoma, developed a new visual field defect. No statistical differences in outcomes between micro- and macroadenoma groups.

Conclusion: Expectedly, most patients undergoing trans-sphenoidal surgery had a pituitary macroadenoma. While surgery is associated with the development of pituitary hormone deficiencies and new visual field defects, our data show that a large proportion of our patients maintained a normal pituitary function and did not develop new visual field defects. Our data are comparable to other trans-sphenoidal surgery centres in the UK and emphasise the importance of a single, dedicated pituitary surgeon.