title: Reasons and results of endoscopic surgery for prolactinomas: 142 surgical cases.
abstract: BACKGROUND
  We report herein a retrospective analysis of the results of 142 consecutive prolactinoma cases operated upon using an endoscopic endonasal trans-sphenoidal approach over a period of 6 years.
  
  
  METHODS
  Medical records of 142 cases were analysed with respect to indications for surgery, duration of hospital stay, early remission rates, failures and recurrence rates during a median follow-up of 36 months.
  
  
  RESULTS
  On the basis of magnetic resonance imaging (MRI) data, 19 patients (13.4 %) had microadenoma, 113 (79.6 %) had macroadenoma, and the remaining 10 (7.0 %) had giant adenomas. Cavernous sinus invasion was identified in 25 patients by MRI and confirmed during surgery. Atypical adenoma was diagnosed in 16 patients. Sparsely granulated prolactin adenoma was identified in 99 patients (69.7 %). Our results demonstrate that male sex and higher preoperative prolactin levels are independent factors predicting persistent disease. The post-surgical complications are as follows: 2.8 % patients had meningitis, 2.1 % patients had postoperative cerebrospinal fluid leak and 2.1 % patients had panhypopituitarism. At the end of follow-up, 74.6 % patients went into remission. During follow-up period, five patients who had initial remission developed recurrence.
  
  
  CONCLUSIONS
  Our series together with literature data suggest that an endoscopic endonasal trans-sphenoidal approach in the treatment of proloctinomas has a favourable rate of remission. According to the findings of this study, endoscopic endonasal trans-sphenoidal surgery might be an appropriate therapy choice for patients with prolactinoma who could not have been managed with recommended therapeutic modalities.
authors.affiliation: Faculty of Medicine, Department of Endocrinology and Metabolism, Hacettepe University, Ankara, Turkey.
authors.forename: Safak
authors.initials: S
authors.lastname: Akin
authors.affiliation: Faculty of Medicine, Department of Neurosurgery, Hacettepe University, Ankara, Turkey.
authors.forename: Ilkay
authors.initials: I
authors.lastname: Isikay
authors.affiliation: Faculty of Medicine, Department of Pathology, Hacettepe University, Ankara, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Soylemezoglu
authors.affiliation: Faculty of Medicine, Department of Otorhinolaryngology, Hacettepe University, Ankara, Turkey.
authors.forename: Taskin
authors.initials: T
authors.lastname: Yucel
authors.affiliation: Faculty of Medicine, Department of Endocrinology and Metabolism, Hacettepe University, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Gurlek
authors.affiliation: Faculty of Medicine, Department of Neurosurgery, Hacettepe University, Ankara, Turkey. msberker@gmail.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Berker
mesh_terms: D000328:Adult; D000368:Aged; D065634:Cerebrospinal Fluid Leak / Q000209:etiology*; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D008297:Male; D008581:Meningitis / Q000209:etiology*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D010911:Pituitary Neoplasms / Q000601:surgery*; D015175:Prolactinoma / Q000601:surgery*; D016896:Treatment Outcome
keywords: Atypical prolactin adenoma; Endoscopic endonasal trans-sphenoidal pituitary surgery; Pituitary apoplexy; Prolactinoma; Sparsely granulated prolactin adenoma