Complications of transsphenoidal surgery in patients with pituitary adenoma

Experience at a single centre

L. R. Barzaghi, M. Losa, M. Giovanelli, P. Mortini

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective. This paper reports the complications of transsphenoidal surgery for pituitary adenomas in a series of 1240 consecutive patients operated at our Institute between 1990 and 2004 (first operations) and indicate the clinical characteristics of patients which affected surgical morbidity and mortality. Methods. According to tumour type, there were 420 (33.9%) non-functioning pituitary adenomas (NFPA), 349 (28.1%) GH-secreting, 288 (23.2%) ACTH-secreting, 155 (12.5%) prolactin (PRL)-secreting, and 28 (2.3%) TSH-secreting adenomas. The mean age of patients was 43.7 ± 0.4 yr and 122 patients (9.9%) were 65 yr or older; the female/male ratio was 1.5/1. There were 370 (29.8%) microadenomas and 870 (70.2%) macroadenomas of which 54 (4.4%) were giant adenomas. Results. The series mortality was 0.2%, the medical morbidity 1.9%, and the surgical morbidity 3.5%. Medical complications were significantly more frequent in patients older than 65 yr (4.9 vs. 1.4%; p = 0.009) and in patients with giant adenomas (5.6 vs. 1.6%; p = 0.03). Multivariate analysis showed that both variables were independently associated with a higher morbidity rate. The surgical morbidity was increased in giant adenomas (15 vs. 3%; p = 0.0001), in NFPA (6.2 vs. 2.1% in secreting adenomas; p = 0.0002) and in patients older than 65 yr (6.6 vs. 3.1%; p = 0.05). Multivariate analysis showed that only giant size was independently associated with an increased surgical morbidity rate. Conclusions. In our experience, the size of the adenoma was a risk factor for medical and surgery related complications and age over 65 yr for medical complications alone.

Original languageEnglish
Pages (from-to)877-885
Number of pages9
JournalActa Neurochirurgica
Volume149
Issue number9
DOIs
Publication statusPublished - Sep 2007

Fingerprint

Pituitary Neoplasms
Adenoma
Morbidity
Multivariate Analysis
Mortality
Prolactin
Adrenocorticotropic Hormone
Neoplasms

Keywords

  • Complications of surgery
  • Pituitary adenoma
  • Pituitary surgery
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Complications of transsphenoidal surgery in patients with pituitary adenoma : Experience at a single centre. / Barzaghi, L. R.; Losa, M.; Giovanelli, M.; Mortini, P.

In: Acta Neurochirurgica, Vol. 149, No. 9, 09.2007, p. 877-885.

Research output: Contribution to journalArticle

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abstract = "Objective. This paper reports the complications of transsphenoidal surgery for pituitary adenomas in a series of 1240 consecutive patients operated at our Institute between 1990 and 2004 (first operations) and indicate the clinical characteristics of patients which affected surgical morbidity and mortality. Methods. According to tumour type, there were 420 (33.9{\%}) non-functioning pituitary adenomas (NFPA), 349 (28.1{\%}) GH-secreting, 288 (23.2{\%}) ACTH-secreting, 155 (12.5{\%}) prolactin (PRL)-secreting, and 28 (2.3{\%}) TSH-secreting adenomas. The mean age of patients was 43.7 ± 0.4 yr and 122 patients (9.9{\%}) were 65 yr or older; the female/male ratio was 1.5/1. There were 370 (29.8{\%}) microadenomas and 870 (70.2{\%}) macroadenomas of which 54 (4.4{\%}) were giant adenomas. Results. The series mortality was 0.2{\%}, the medical morbidity 1.9{\%}, and the surgical morbidity 3.5{\%}. Medical complications were significantly more frequent in patients older than 65 yr (4.9 vs. 1.4{\%}; p = 0.009) and in patients with giant adenomas (5.6 vs. 1.6{\%}; p = 0.03). Multivariate analysis showed that both variables were independently associated with a higher morbidity rate. The surgical morbidity was increased in giant adenomas (15 vs. 3{\%}; p = 0.0001), in NFPA (6.2 vs. 2.1{\%} in secreting adenomas; p = 0.0002) and in patients older than 65 yr (6.6 vs. 3.1{\%}; p = 0.05). Multivariate analysis showed that only giant size was independently associated with an increased surgical morbidity rate. Conclusions. In our experience, the size of the adenoma was a risk factor for medical and surgery related complications and age over 65 yr for medical complications alone.",
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AB - Objective. This paper reports the complications of transsphenoidal surgery for pituitary adenomas in a series of 1240 consecutive patients operated at our Institute between 1990 and 2004 (first operations) and indicate the clinical characteristics of patients which affected surgical morbidity and mortality. Methods. According to tumour type, there were 420 (33.9%) non-functioning pituitary adenomas (NFPA), 349 (28.1%) GH-secreting, 288 (23.2%) ACTH-secreting, 155 (12.5%) prolactin (PRL)-secreting, and 28 (2.3%) TSH-secreting adenomas. The mean age of patients was 43.7 ± 0.4 yr and 122 patients (9.9%) were 65 yr or older; the female/male ratio was 1.5/1. There were 370 (29.8%) microadenomas and 870 (70.2%) macroadenomas of which 54 (4.4%) were giant adenomas. Results. The series mortality was 0.2%, the medical morbidity 1.9%, and the surgical morbidity 3.5%. Medical complications were significantly more frequent in patients older than 65 yr (4.9 vs. 1.4%; p = 0.009) and in patients with giant adenomas (5.6 vs. 1.6%; p = 0.03). Multivariate analysis showed that both variables were independently associated with a higher morbidity rate. The surgical morbidity was increased in giant adenomas (15 vs. 3%; p = 0.0001), in NFPA (6.2 vs. 2.1% in secreting adenomas; p = 0.0002) and in patients older than 65 yr (6.6 vs. 3.1%; p = 0.05). Multivariate analysis showed that only giant size was independently associated with an increased surgical morbidity rate. Conclusions. In our experience, the size of the adenoma was a risk factor for medical and surgery related complications and age over 65 yr for medical complications alone.

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