Residual anterior pituitary function following transsphenoidal resection of pituitary macroadenomas

✓ A series of 84 patients with pituitary adenomas greater than 1 cm in diameter is presented. Full preoperative and postoperative endocrine evaluations were carried out, and the effects of transsphenoidal surgery on remaining anterior pituitary function were analyzed. Of the patients who had normal anterior pituitary function before surgery, 78% retained normal function after surgery. Thirty-three percent of those patients with pituitary deficits who did not have panhypopituitarism before surgery had improved function after surgery; 33% had worsened function after surgery. None of the patients with panhypopituitarism before surgery regained function after surgery. Transsphenoidal surgery carries an acceptable risk for sacrificing anterior pituitary function, but the risk is greater in patients with larger tumors and preoperatively compromised pituitary function.

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Residual anterior pituitary function following transsphenoidal resection of pituitary macroadenomas

Prolactinomas, An interdisciplinary approach ◽

10.1515/9783110853858-037 ◽

2015 ◽

Author(s):

D. P. Becker ◽

A. T. Nelson ◽

H. St. G. Tucker

Keyword(s):

Anterior Pituitary ◽

Pituitary Function ◽

Anterior Pituitary Function ◽

Pituitary Macroadenomas ◽

Transsphenoidal Resection

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Anterior Pituitary Function before and after Trans-sphenoidal Microsurgical Resection of Pituitary Tumors

Neurosurgery ◽

10.1227/00006123-197809000-00002 ◽

1978 ◽

Vol 3 (2) ◽

pp. 142-145 ◽

Cited By ~ 36

Author(s):

Scott C. McLanahan ◽

James H. Christy ◽

George T. Tindall

Keyword(s):

Surgical Management ◽

Anterior Pituitary ◽

Pituitary Tumors ◽

Anterior Lobe ◽

Normal Function ◽

Pituitary Function ◽

Small Series ◽

Before And After ◽

Anterior Pituitary Function ◽

Microsurgical Resection

Abstract Anterior pituitary lobe function was measured pre- and postoperatively in 40 patients with pituitary tumors who were managed surgically by the trans-sphenoidal approach. Of 23 patients with normal anterior lobe function preoperatively, 21 (91%) were normal postoperatively. Of 17 preoperatively impaired patients, 7 (40%) regained normal function, 3 (18%) improved, 4 (24%) remained the same, and 3 (18%) were further impaired by the surgery. In this small series, the likelihood of recovery of pituitary function varied inversely with the degree of preoperative impairment and the size of the tumor, suggesting that more aggressive surgical management of small, minimally symptomatic pituitary tumors is justified.

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Neurosurgical management of acromegaly

Journal of Neurosurgery ◽

10.3171/jns.1979.50.4.0454 ◽

1979 ◽

Vol 50 (4) ◽

pp. 454-461 ◽

Cited By ~ 78

Author(s):

Edward R. Laws ◽

David G. Piepgras ◽

Raymond V. Randall ◽

Charles F. Abboud

Keyword(s):

Anterior Pituitary ◽

Transsphenoidal Surgery ◽

Operative Mortality ◽

Human Growth ◽

Consecutive Series ◽

Content Type ◽

Transsphenoidal Microsurgery ◽

Anterior Pituitary Function ◽

Invasive Adenoma

✓ A consecutive series of 82 acromegalic patients who underwent transsphenoidal surgery during a 5-year period is presented. Preoperative and postoperative values for human growth hormone (HGH) were available in 80 cases. Microadenomas were present in 18 patients with a mean preoperative HGH value of 25.2 ng/ml, diffuse adenomas in 39 patients with mean of 53.8 ng/ml, and invasive adenomas in 25 with mean of 68.0 ng/ml. There was no operative mortality. The results reflected the classification of the tumors, with apparent cures accomplished in 87.5% of previously untreated patients with microadenoma, all of whom had anterior pituitary function preserved. The percentages of apparent cures in cases of diffuse adenoma (68%) and invasive adenoma (54%) were much less satisfactory. Transsphenoidal microsurgery is capable of achieving good results, particularly in patients with microadenoma.

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