Endocrine Abstracts (2011) 25 P242

Pitfalls in transphenoidal surgery: a 10 years experience

Kanchan Mukherjee, Virender Khosla, Suresh Mathuriya, Anil Bhansali, Pinaki Dutta, Nilanjan Khandelwal, Paramjeet Singh, Rakesh Vasishta, Bhisham Radotra, Ashis Pathak, Sunil Gupta, Manoj Tewari & Rajesh Chhabra


Postgraduate Institute of Medical Education and Research, Chandigarh, India.


Three hundred and thirty six cases of pituitary adenomas were operated by the transpenoidal route in the last 10 years by a single surgeon. Majority of these were giant non functioning adenomas. Prolactinomas were excluded unless a part of dual adenoma.

In nearly 80% of tumours, total or near total removal was achieved. Long term outcome with follow up of more than 5 years revealed recurrence requiring resurgery in only 4 out of 102 patients. Endocrine recovery was seen in many with permanent added hormonal deficit in around 5% of cases. Added visual deficit was seen in 1 patient.

Mortality was 14 patients and the avoidable reasons will be discussed.The advantages and disadvantages of an aggressive approach in a developing country were the cost of hormonal supplementation is prohibitive will be highlighted.