| Impact of primary surgery on pituitary function in patients with non-functioning pituitary adenomas -- a study on 721 patients. | |
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MedLine Citation:
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PMID: 14740262 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The aim of this study was to define the impact of surgery on pituitary function in a large consecutive series of patients harbouring non-functioning pituitary adenomas. MATERIALS AND METHOD: Between December 1982 and December 2000, a total of 822 patients underwent primary surgery in the authors' department. In 721 cases a complete set of endocrinological data was available. Functions of the pituitary-gonadal, pituitary-thyroid and pituitary-adrenal axes were assessed immediately before surgery and again one week, 3 months and 1 year after the operation, utilizing standardized tests and commercially available assays. RESULTS: There was some degree of pre-operative hypopituitarism in 561 (85%) and 53 (86.3%) of the patients belonging to the transsphenoidal and the transcranial groups, respectively. Prior to transsphenoidal [transcranial] surgery, 163 (31%) [34 (55.7%)] of the patients had secondary adrenal deficiency, 463 (76.6%) [49 (89%)] had hypogonadism and 105 (19.1%) [14 (25.4%)] were hypothyroid. Preoperatively, prolactin levels were mildly elevated in 167 patients (25.3%), whereas 1 year after surgery, levels were elevated in only 5 patients. Permanent diabetes insipidus occurred in 4 patients, 2 from the transsphenoidal group (0.3%) and 2 from the transcranial group (3.2%). Following transsphenoidal surgery 110 (19.6%) of patients had normal pituitary function [versus 0% after transcranial surgery], 169 (30.1%) [6 (11.3%)] showed improvement, 274 (48.9%) [49 (73.7%)] had persistent deficits and 8 (1.4%) [8 (15%)] showed deterioration of pituitary function. DISCUSSION: These data indicate that transsphenoidal surgery for non-functioning pituitary adenomas in expert hands is, relatively, far less detrimental to patients compared with transcranial surgery. The latter carries a much greater risk of post-operative deterioration in pituitary function. |
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Authors:
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P Nomikos; C Ladar; R Fahlbusch; M Buchfelder |
Publication Detail:
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Type: Journal Article Date: 2004-01-07 |
Journal Detail:
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Title: Acta neurochirurgica Volume: 146 ISSN: 0001-6268 ISO Abbreviation: Acta Neurochir (Wien) Publication Date: 2004 Jan |
Date Detail:
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Created Date: 2004-01-23 Completed Date: 2004-10-19 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: Austria |
Other Details:
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Languages: eng Pagination: 27-35 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany. nomikos@med.uni-goettingen.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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pathology,
surgery* Adolescent Adult Aged Aged, 80 and over Child Diabetes Insipidus / etiology Female Humans Hypogonadism / etiology Male Middle Aged Pituitary Diseases / etiology* Pituitary Gland / physiology* Pituitary Neoplasms / pathology, surgery* Postoperative Complications* Professional Competence Retrospective Studies Sphenoid Bone / surgery Treatment Outcome |
| Comments/Corrections | |
Erratum In:
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Acta Neurochir (Wien). 2004 Apr;146(6):433 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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