Endocrine Abstracts

Background: Non-functioning pituitary adenomas (NFPAs) are the most common pituitary macroadenomas with a prevalence of 7-22 per 100,000 population. As they are non-secretory, they tend to present late with visual disturbances, headaches or hormonal deficiencies. Surgery is the main treatment for NFPAs, particularly endoscopic transsphenoidal surgery which can be associated with surgical and endocrine complications.

Aims: To compare pre- and post-operative endocrine outcomes and surgical complications and benchmark the findings with similar published cohorts

Methods: The clinical and laboratory records of 71 NFPA patients who underwent endoscopic pituitary surgery between 2017-2018 at Southampton General Hospital/UK were reviewed to note their pre-and post-operative endocrine and surgical outcomes. This included assessing of thyroid, adrenal, growth hormone and gonadotrophin axes, clinical hormone deficiencies and post-surgical complications. The data was tabulated for each individual patient and statistically analysed using SPSS for both quantitative and descriptive parameters.

Results: In our cohort, there was little increase in the proportion of patients with hypocortisolism and hypogonadism post-operatively compared with pre-operatively increasing from 31.0% (22/71) to 38.0% (27/71) and from 19.7% (14/71) to 21.1% (15/71) respectively. There was no post-operative increase in the 31% (22/71) of patients with hypothyroidism pre-operatively.11.3% (8/71) of the patients developed diabetes insipidus post-operatively. The most common surgical complication was intra-operative CSF leak affecting 19.7% (14/71) of the patients with 1.4% (1/71) of the cohort having post-operative CSF leaks. Post-surgically, epistaxis affected 7.0% (5/71), deterioration of vision affected 5.6% (4/71). The Wilcoxon Signed Rank Test demonstrated the increase on the number of hormone deficiencies per patient post-operatively was not statistically significant (P=0.751). Only 44 patients had their post-operative visual status recorded, 56.8% (25/44) of these had improved vision post-op, 34.1% (15/44) remained stable while 9.1% (4/44) worsened.

Conclusion: Visual status is mostly improved by transsphenoidal surgery. Additionally, endocrine function is only slightly worse following pituitary surgery. Our cohort’s endocrine and surgical outcomes are comparable to the findings in previously published studies.