[Surgery of pituitary adenoma]

The transsphenoidal approach is used in 99% of pituitary adenomas cases. In this kind of surgery, mechanical and endocrinological complications are rare. The visual disturbances of the huge macroadenomas are easily cured if the patient is operated on before optic atrophy. In secreting adenomas the cure of the hypersecretion depends mainly on the tumor size and is obtained in 90% or 95% of microadenomas. Recurrencies may occur in 10% or 15% of patients; if they are easily diagnosed in hypersecreting tumors they must be systematically searched for in ron secreting adenomas which require a regular follow-up.