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Endocrine Abstracts (2018) 56 P769 | DOI: 10.1530/endoabs.56.P769

ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Neuroendocrinology (28 abstracts)

Clinical outcomes and complications in Endoscopic transsphenoidal pituitary surgery (ETPS) for Non-functioning pituitary adenomas

Pablo Remon-Ruiz 1 , Elena Dios 1 , Eva Venegas 1 , Eugenio Cardenas 1 , Ariel Kaen 1 , Natividad Garcia 2 , Florinda Roldan 1 , Elena Fajardo 1 , David Cano 1 & Alfonso Soto 1


1University Hospital Virgen del Rocio, Sevilla, Spain; 2University Hospital Virgen Macarena, Sevilla, Spain.


Methods: We conducted a retrospective descriptive study including 67 patients with non-functioning pituitary adenomas surgicaly removed via ETPS beetwen January/2013 to January/2017.

Results: Among 67 patients with non-functioning pituitary adenomas surgicaly removed via ETPS 44 (65.67%) were men. 52 (77.61%) patients recieved their first surgery, 14 (20.9%) had been operated one time before and 1 (1.49%) had been operated two times. Every patient reoperated had been previously operated by transsphenoidal microscopic approach before ETPS. Presurgical median age was 55.53 [44.09–69.38] years and median follow-up was 3.67 [2.25–5.69] years. Presurgically, 37 (56.06%) patients showed thyroid dysfunction, 18 (27.27%), steriod dysfunction, 41 (62.12%) gonadal dysfunction and 25 (37.88%) somatotropic deficiency. 16 (23.88%) adenomas were null cell, 11 (16.42%) silent corticotroph, 3 (4.48%) silent somatotroph (1 showed PRL cosecretion), 2 PRL (2.99%), 1 (1.49%) TSH, and the other were gonadotroph adenomas. 6 (8.96%) showed Ki>3%. Median utmor size was 27 [21.7–33.7] mm, 45 (67.16%) showed a size >25 mm and 29 (43.28%) Knosp 3–4. 52 (77.61%) were operated by first time. 36 (69.23%) patients showed healing criteria at the end of observation, 4 (7.69%) tumor remaining <1 cm and 11 (21.15%) had tumor remaining >1 cm. Among 23 patients with Knos 3–4, 13 (56.52%) showed healing criteria. Every patients with tumor remains >1 cm were adenomas >25 mm, 10 (90.9%) showed cavernous sinus invasion. 33 (63.46%) showed presurgical campymetric defects; 21 (63.63%) resolved completely their campimetric defects, 10 (30.3%) showed a partial resolution and no changes were found in 2 (6.06%) patients. After surgery, transient diabetes insipidous was diagnosed in 15 (28.84%) patients, DI permanent in 2 (3.85%), transient SiADH was found in 3 (5.77%). Among patient without hormone involvement, 8 (34.78%) developed a steroid deficiency and 9 (42.86%) gonadal defect. 1 suspected meningitis was observed. Among reoperated patients. 6 (40%) had healing criteria, 3 (20%) tumor remaining <1 cm and 6 (40%) tumor remaining >1 cm. 1 patient showed a meningitis. As complications 1 patient presented a suspected meningitis. 7 (46.67%) patients had campimetric defects, after surgery 1 (14.29%) resolved completely their campimetric defects, 6 (85.71%) showed an improvement. After surgery, among patients without endocrine involvement, 3 (42.86%) presented thyroid deficiency, 3 (33.33%) steroid, 1 (25%) gonadal deficiency.

Conclusions: In our series, ETPS have shown better outcomes than transsphenoidal microscopic approach if we compare our series with the literature. This approach leads to complete curation in patients with sinus involvement.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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