Endocrine Abstracts

Methods: We conducted a retrospective descriptive study including 67 patients with non-functioning pituitary adenomas surgicaly removed via ETPS beetwen January/2013 to January/2017.

Results: Among 67 patients with non-functioning pituitary adenomas surgicaly removed via ETPS 44 (65.67%) were men. 52 (77.61%) patients recieved their first surgery, 14 (20.9%) had been operated one time before and 1 (1.49%) had been operated two times. Every patient reoperated had been previously operated by transsphenoidal microscopic approach before ETPS. Presurgical median age was 55.53 [44.09–69.38] years and median follow-up was 3.67 [2.25–5.69] years. Presurgically, 37 (56.06%) patients showed thyroid dysfunction, 18 (27.27%), steriod dysfunction, 41 (62.12%) gonadal dysfunction and 25 (37.88%) somatotropic deficiency. 16 (23.88%) adenomas were null cell, 11 (16.42%) silent corticotroph, 3 (4.48%) silent somatotroph (1 showed PRL cosecretion), 2 PRL (2.99%), 1 (1.49%) TSH, and the other were gonadotroph adenomas. 6 (8.96%) showed Ki>3%. Median utmor size was 27 [21.7–33.7] mm, 45 (67.16%) showed a size >25 mm and 29 (43.28%) Knosp 3–4. 52 (77.61%) were operated by first time. 36 (69.23%) patients showed healing criteria at the end of observation, 4 (7.69%) tumor remaining <1 cm and 11 (21.15%) had tumor remaining >1 cm. Among 23 patients with Knos 3–4, 13 (56.52%) showed healing criteria. Every patients with tumor remains >1 cm were adenomas >25 mm, 10 (90.9%) showed cavernous sinus invasion. 33 (63.46%) showed presurgical campymetric defects; 21 (63.63%) resolved completely their campimetric defects, 10 (30.3%) showed a partial resolution and no changes were found in 2 (6.06%) patients. After surgery, transient diabetes insipidous was diagnosed in 15 (28.84%) patients, DI permanent in 2 (3.85%), transient SiADH was found in 3 (5.77%). Among patient without hormone involvement, 8 (34.78%) developed a steroid deficiency and 9 (42.86%) gonadal defect. 1 suspected meningitis was observed. Among reoperated patients. 6 (40%) had healing criteria, 3 (20%) tumor remaining <1 cm and 6 (40%) tumor remaining >1 cm. 1 patient showed a meningitis. As complications 1 patient presented a suspected meningitis. 7 (46.67%) patients had campimetric defects, after surgery 1 (14.29%) resolved completely their campimetric defects, 6 (85.71%) showed an improvement. After surgery, among patients without endocrine involvement, 3 (42.86%) presented thyroid deficiency, 3 (33.33%) steroid, 1 (25%) gonadal deficiency.

Conclusions: In our series, ETPS have shown better outcomes than transsphenoidal microscopic approach if we compare our series with the literature. This approach leads to complete curation in patients with sinus involvement.