Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 26 P214

ECE2011 Poster Presentations Pituitary (111 abstracts)

Multimodal treatment and minimally invasive surgery for 117 pituitary adenomas: a Croatian Pituitary Centre experience

Ivan Kruljac 1 , Andreja Maric 1 , Petra Sulentic 1 , Maja Berkovic Cigrovski 1 , Davorka Herman Mahecic 1 , Gorana Mirosevic 1 , Darko Kastelan 2 & Milan Vrkljan 1

1University Hospital Sisters of Mercy, Zagreb, Croatia; 2University Hospital Centre Zagreb, Zagreb, Croatia.

Studies that consolidate the results of medicamentous and surgical treatment of pituitary adenomas are scarce. Pure endoscopic endonasal transsphenoidal surgery is rather new technique.

The aim of this study is to report on early postoperative outcome of pure endoscopic endonasal transsphenoidal surgery and to present the results of multimodal treatment in patients with postsurgical failure.

We reviewed 117 consecutive patients who underwent pure endoscopic transsphenoidal adenomectomy in Croatian reference Pituitary Centre over one year period (year 2007). Postoperative success was defined as normalization of hormonal excess, and was assessed 6 weeks after surgery. Residue in non-functional (NF) tumors were analysed by magnetic resonance 6 months postoperatively. The series consisted of 21 somatotrophic (GH) adenomas, 61 prolactinomas, four corticotrophic (ACTH) and 31 NF adenomas.

Biochemical criteria for early postoperative remission were obtained in 15 (71.4%) patients with somatotrophic adenoma, 55 (90.2%) patients with prolactinoma, three (75%) patients with corticotrophic adenoma and in 25 (80.6%) patients with NF adenomas. After medicamentous treatment (somatostatin and bromocriptine), gamma knife surgery in seven patients and reoperation in three patients, 4.7% patients with GH adenoma, 3.3% with prolactinoma and 12.9% with NF adenoma remained reluctant to treatment.

In conclusion, pure endoscopic technique is an effective method in pituitary surgery. Our results are similar to those in greater centres. In early postoperative failure multimodal treatment improves the remission rate. The multidisciplinary approach is the key to successful treatment of pituitary tumors.

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