ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Neuroendocrinology (28 abstracts)
ACTH-secreting pituitary adenomas surgical outcomes and complications in Endoscopic transsphenoidal pituitary surgery (ETPS)
Pablo Remon-Ruiz 1 , Elena Dios-Fuentes 1 , Eva Venegas 1 , Ariel Kaen 1 , Eugenio Cardenas 1 , Natividad Garcia 2 , Florinda Roldan 1 , Elena Fajardo 1 , David Cano 1 & Alfonso Soto 1
1University Hospital Virgen del Rocio, Sevilla, Spain; 2University Hospital Virgen Macarena, SEVILLA, Spain.
Methods: Descriptive retrospective study among patients who underwent ETPS for ACTH-secreting pituitary adenomas performed by the same surgical team from January/2013 to January/2017.
Results: 27 ACTH-secreting pituitary adenomas operated via ETPS. 20 (74.1%) were women, median age at surgery was 43.25 [29.65–61.59] years and median follow-up was 3.13 [1.6–6.69] years. Presurgically, 25 (92.59%) patients recieved drugs for control cortisol hypersecretion; all 25 recieved Ketoconazol, in the other 2 (7.41%) the treatment (ketoconazol) was discontinued due to hypertransaminasemia. Median presurgical dosage was 600 [400–600] mg/día. 8 (29.62%) patients were macroadeomas with a median size of 6.55 [5–12] mm. 1 (3.7%) showed a Ki expression >3% and 3 (11.1%) patients showed cavernous sinus invasion. 19 (70.37%) patients were operated by first time, 7 (25.93%) had been previously operated one time and 1 (3.7) had been operated two times before the ETPS aproach. 16 (84.21%) of the first operated patients showed at the end of observation period healing criteria, 2 of them were precociously reoperated due to tumor remains were observed in postsurgical MRI. Among first operated patients 4 were macroadenomas, and all of them were disease-free at the end of observation period; 15 were microadenomas and 12 (80%) were disease-free at the end of the study. After the surgery, 13 (68.42%) developed transient diabetes insipidous, 2 (10.53%) patients thyroid dysfunction, 11 (57.89%) steroid dysfunction and 1 (5.26%) gonadal one. 1 patient showed presurgical campymetric defects which showed an improvement after de surgery. 8 patients operated in this period had been operated previously via transsphenoidal microscopical. At the end of the observation period 6 (75%) patients were disease free. Al complications after surgery in reoperated patients, 1 patient showed a suspected meningitis and hydrocefalus. 3 (37.5%) developed postsurgical DI, 1 (12.5%) steroid dysfunction and 1 (12.5%) thyroid dysfunction.
Conclusions: In our series, ETPS showed better results than microscopic approach if we compare our series with the literature and no further complications were found. ETPS is shown as a very useful thecnique in patients previously operated by a microcopic approach.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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