Transsphenoidal microscopic pituitary surgery: A retrospective assessment of remition and complication rates

Aim Surgery has an important place in the treatment of pituitary adenomas. Transsphenoidal microscopic surgery emerges as an effective option. In our study, we aimed to evaluate the postoperative examination results and cure/remission rates of patients with pituitary adenoma who were operated by a single surgeon. Materials and Methods Our study included 111 patients who had been operated by a single surgeon with the transsphenoidal microscopic approach. Hormone activities of the patients were classified and adenoma sizes were evaluated as preop. It was tried to determine whether they met the cure/remission criteria by reaching the examinations performed in the postoperative period. Results In the evaluations, it was seen that 63.9% of the 111 patients met the cure/remission criteria. It was determined as 74.1% in patients with acromegaly, 80% in Cushing's patients, 42.8% in patients with prolactinoma and 43.3% in patients with non-functioning adenoma. It was observed that the criteria for cure/remission were met in 93.3% in microadenomas, 65.1% in macroadenomas and 10% in giant adenomas. While 36.9% of patients with adenoma of all sizes and types with cavernous sinus invasion had cure/remission criteria, this rate increased to 87% in patients with adenoma of all sizes and types without cavernous sinus invasion. 12.6% transient diabetes insipidus, 7.2% rhinorrhea, 1.8% bleeding complications were seen. Persistent diabetes insipidus, infection, pituitary insufficiency could not be detected. Mortality was determined as 0.9%. Conclusion Transsphenoidal microscopic surgery emerges as an alternative in the surgical treatment of pituitary adenomas. It is an effective method with successful results and low complication rates, especially in the surgical treatment of pituitary adenomas without parasellar and suprasellar extension, with its advantages as well as its disadvantages