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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical
Venkatram Subramanian1, Rachel Su Min Lee2, Simon Howell1
1Department of Endocrinology & Metabolism, Royal Preston Hospital, The Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
Endocrine
|April 6, 2021
Summary
Transsphenoidal resection for non-functioning pituitary macroadenomas (NFPAs) offers a 71.5% five-year recurrence-free survival. Surgery significantly improves vision in most patients, with younger age predicting higher recurrence risk.
Area of Science:
- Neurosurgery
- Endocrinology
- Ophthalmology
Background:
- Non-functioning pituitary macroadenomas (NFPAs) often cause visual field defects.
- Transsphenoidal tumour resection is the primary treatment for NFPAs with visual impairment.
- Long-term surveillance is crucial for detecting tumor recurrence.
Purpose of the Study:
- To assess outcomes of transsphenoidal resection for NFPAs.
- To identify factors influencing recurrence and patient outcomes.
- To evaluate visual and endocrine recovery post-surgery.
Main Methods:
- Retrospective analysis of 105 patients with NFPAs treated between 2008-2019.
- Assessment of pre- and postoperative visual, endocrine, and imaging data.
- Evaluation of surgical outcomes, complications, and recurrence rates.
Main Results:
- Five-year recurrence-free survival was 71.5%.
- 92% of patients with visual field defects showed improvement post-surgery.
- Younger age was a significant predictor of recurrence (HR 0.95).
- Complications included CSF leak (12%), meningitis (2%), and bleeding (2%).
Conclusions:
- Transsphenoidal resection is effective for NFPAs, with good visual recovery rates.
- Older age at surgery is associated with a lower risk of recurrence.
- Continued monitoring is essential due to potential recurrence and complications.
