Experience of trans-sphenoidal excision of pituitary adenomas in a tertiary care hospital in Pakistan.
To determine the presentation, indications, management and clinical outcomes of patients who underwent trans-sphenoidal excision of pituitary adenomas in a tertiary care setting.
The retrospective, descriptive study was conducted at the Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, and comprised records of patients with pituitary adenoma who underwent trans-sphenoidal excision between July 2005 and September 2022. Data was analysed using STATA 15.1.
Of the 50 patients, 25(50%) were males and 25(50%) were females. The overall mean age was 43.16±12 years. In 35(70%) cases, tumours were invading the cavernous sinus and were partially resected, 32(64%) tumours were macroadenoma, and 36(72%) were non-secretory. Of the total, 29(58%) patients were discharged within eight days of surgery. Intraoperative cerebrospinal fluid leak was seen in 4(8%) patients. Postoperative complications included anterior pituitary deficiency 17(34%), posterior pituitary deficiency 13(26%) and panhypopituitarism 3(6%). Postoperatively, vision improved in 23(46%) patients. External radiation therapy was offered to 15(30%) patients, while 5(10%) had gamma knife therapy.
Patients with non-functioning pituitary adenomas mostly presented later in life, with large adenomas causing compressive symptoms.
The retrospective, descriptive study was conducted at the Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, and comprised records of patients with pituitary adenoma who underwent trans-sphenoidal excision between July 2005 and September 2022. Data was analysed using STATA 15.1.
Of the 50 patients, 25(50%) were males and 25(50%) were females. The overall mean age was 43.16±12 years. In 35(70%) cases, tumours were invading the cavernous sinus and were partially resected, 32(64%) tumours were macroadenoma, and 36(72%) were non-secretory. Of the total, 29(58%) patients were discharged within eight days of surgery. Intraoperative cerebrospinal fluid leak was seen in 4(8%) patients. Postoperative complications included anterior pituitary deficiency 17(34%), posterior pituitary deficiency 13(26%) and panhypopituitarism 3(6%). Postoperatively, vision improved in 23(46%) patients. External radiation therapy was offered to 15(30%) patients, while 5(10%) had gamma knife therapy.
Patients with non-functioning pituitary adenomas mostly presented later in life, with large adenomas causing compressive symptoms.
Authors
Butt Butt, Bhatti Bhatti, Tariq Tariq, Khalid Khalid, Ghaloo Ghaloo, Yousaf Yousaf
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