title: Immediate and delayed postoperative morbidity in functional and non-functioning pituitary adenomas.
abstract: Neurosurgery is the most widely used definite treatment for pituitary tumors, while medical treatments are a good option to improve symptoms, which tend to recur when drugs are stopped. The aim of this study was to assess postsurgical morbidity of secreting pituitary adenomas (adrenocorticotropin hormone -ACTH- and growth hormone -GH- secreting) and non-functioning (NF) adenomas, operated between January 2002 and May 2009. We retrospectively reviewed the data of 94 patients who were operated by the same neurosurgeons and compared the immediate (1st month) and delayed (1st year) complications between the three groups of adenomas. Forty had immediate post-operative complications (42% of NF, 37% of GH-secreting and 48% of ACTH-secreting adenomas). The most frequent complications were transient diabetes insipidus (23%), cerebrospinal fluid leaks (7%), sinusitis and meningitis (2%). Patients with Cushing's disease showed a tendency to have more transient diabetes insipidus and sinusitis compared to NF adenomas (P = 0.071). Ten patients had delayed complications during the first post-operative year (7% of NF, 11% of GH-secreting and 15% of ACTH-secreting), with a greater incidence of arthromyalgias and acute carpal tunnel syndrome in ACTH-secreting adenomas, compared with the other groups (P < 0.05). We conclude, that although ACTH-secreting adenomas are mostly microadenomas (78%) and affect younger patients, they are associated with a greater number of immediate and delayed complications during the first postoperative year (mainly invalidating arthromyalgias and acute carpal tunnel syndrome) compared with larger GH-secreting and NF adenomas, probably related to acute glucocorticoid deprivation after successful surgery.
authors.affiliation: Centro de Atención Especializada, CAP Roger de Flor, Dreta de l'Eixample Barcelona, Roger de Flor 194, 08013, Barcelona, Spain. AAulinasM@gmail.com
authors.forename: Anna
authors.initials: A
authors.lastname: Aulinas
authors.forename: Cristina
authors.initials: C
authors.lastname: Colom
authors.forename: Juan
authors.initials: J
authors.lastname: Ybarra
authors.forename: Fernando
authors.initials: F
authors.lastname: Muñoz
authors.forename: Pere
authors.initials: P
authors.lastname: Tresserras
authors.forename: Eugenia
authors.initials: E
authors.lastname: Resmini
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
mesh_terms: D049913:ACTH-Secreting Pituitary Adenoma / Q000150:complications* / Q000601:surgery; D000236:Adenoma / Q000150:complications* / Q000601:surgery; D000328:Adult; D000368:Aged; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D047748:Pituitary ACTH Hypersecretion / Q000150:complications; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D019382:Human Growth Hormone