Abstract
IntroductionThe present study analysed the (i) remission and preservation of hormones, (ii) endocrinological and anatomical complications and (iii) visual improvement after endoscopic transsphenoidal surgery (ETS).MethodsThe retrospective observational study of all consecutive cases of pituitary adenoma treated with ETS in Hospital Kuala Lumpur (HKL) between 2006 and 2015. Age, sex, pre- and post-operative hormone level, tumour size, and complications were noted.ResultsA total of 67 patients were diagnosed with non-functioning pituitary adenoma throughout this period. Of these, 11 patients had both visual and hormonal improvement post-operation. Of the 27 patients with tumour invaded into the cavernous sinus, 13 showed an improved vision. In the adenoma patients who had impaired hormonal function before the surgery, the hormone level normalised post-surgery in 42 patients. Moreover, 39 patients were diagnosed with functioning pituitary adenoma. Ten patients recovered from acromegaly and four patients recovered from Cushing disease within seven days post-operative. Also, five patients with functioning adenoma suffered complications.ConclusionOutcome for the preservation and hormone recovery in non-functioning pituitary adenoma group was satisfactory, with only one patient’s hormonal level worsening. No visual deterioration and mortality were detected throughout this study. A dedicated team specialised in endoscopic transsphenoidal pituitary surgery further improved the outcome of this surgical method.
Highlights
The present study analysed the (i) remission and preservation of hormones, (ii) endocrinological and anatomical complications and (iii) visual improvement after endoscopic transsphenoidal surgery (ETS)
The present retrospective observational study consisted of all consecutive cases of pituitary adenoma treated with endoscopic transsphenoidal surgery (ETS) in Hospital Kuala Lumpur (HKL) between 2006 and 2015
This study showed that there were more complications for functioning pituitary adenoma with 5.1% (n = 2) of the patients suffering postoperative bleeding, cerebrospinal fluid (CSF) leak 5.1% (n = 2), and rhinological problem 2.6% (n = 1) as compared to non-functioning pituitary adenoma, wherein only 4.5% (n = 3) of the patients suffered post-operative complications due to CSF leak (Table 7)
Summary
The present study analysed the (i) remission and preservation of hormones, (ii) endocrinological and anatomical complications and (iii) visual improvement after endoscopic transsphenoidal surgery (ETS). Surgical approaches to the pituitary region have undergone numerous refinements over the last 100 years. Diseases of the pituitary gland demand a holistic and multidisciplinary approach. Surgery is a well-established first-line treatment for a host of pituitary lesions. Surgical decompression of the pituitary gland and its stalk may lead to the recovery of hypopituitarism caused by all forms of adenoma in up to 60% of the patients. The primary goal of surgery in pituitary lesions is the maximal removal of the tumour while preserving the gland function [1]. Malays J Med Sci. May–Jun 2019; 26(3): 64–71
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