Comparison of preop and postop radiological, biochemical, hormonal and histopathological parameters in patients operated for pituitary adenoma

Objective: In our study, we aimed to evaluate the preoperative and postoperative early and late hormonal functions of patients with pituitary adenoma, the success rate of surgical treatment and the correlation of this rate with Knosp classification. Materials and Methods: Our study included patients operated for pituitary adenoma and was conducted retrospectively. One hundred patients were included in the study. Preoperative, postoperative day one and postoperative thirth month radiological, biochemical and hormonal values of these patients were evaluated. Results: The changes in growth hormone, insulin-like factor-1, cortisol, thyroid stimulating hormone, free T4, follicle stimulating hormone and luteinising hormone values at preoperative, postoperative day 1 and week 12 were statistically significant (p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p=0.012, respectively). Growth hormone, insulin-like factor-1, luteinising hormone and prolactin values at week 12 were found to be lower than preoperative values (p<0.001; p<0.001; p<0.001; p=0.035; p<0.001, respectively), while free T4 value was found to be higher than preoperative value (p=0.044). When the cases were evaluated according to the KNOSP classification, it was found that 6 cases were grade 0, 13 cases were grade 1, 21 cases were grade 2, 14 cases were grade 3A, 9 cases were grade 3B and 37 cases were grade 4. Among these cases, it was observed that all of the grade 1 and grade 0 group met the remission criteria. As the grade increased, the rate of residual disease increased. Among the patients who developed diabetes insipidus, 5 (45.5%) patients with grade 4, 2 (18.5%) patients with grade 1, 2 (18.5%) patients with grade 2, and 2 (18.5%) patients with grade 3A had DI clinic. Conclusion: After pituitary surgery, a significant decrease was observed in the hormonal values of patients with adenoma. Close follow-up of the patients by an experienced endocrinologist and surgeon is important for early detection and treatment of recurrence and postoperative complications. Keywords: Pituitary, adenoma, acromegaly, cushing, surgery, cortisol, prolactin