Effect of pituitary adenoma consistency on surgical outcomes in patients undergoing endonasal endoscopic transsphenoidal surgery

Background Most pituitary adenomas (PAs) are considered to have a soft tumor consistency. However, there is a non-negligible percentage (5–13%) of tumors presenting or exhibiting a fibrous consistency that would entail a more difficult and complicated surgical excision with higher surgical morbidity...

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Bibliographic Details
Published in:Endocrine 2022-12, Vol.78 (3), p.559-569
Main Authors: Acitores Cancela, A., Rodríguez Berrocal, V., Pian Arias, H., Díez, J. J., Iglesias, P.
Format: Article
Language:English
Subjects:
Adenoma
Cerebrospinal fluid
Diabetes
Diabetes insipidus
Endocrinology
Endoscopy
Humanities and Social Sciences
Hypopituitarism
Internal Medicine
Magnetic resonance imaging
Medicine
Medicine & Public Health
Morbidity
multidisciplinary
Neurosurgery
Original Article
Patients
Pituitary
Radiation therapy
Science
Surgery
Surgical outcomes
Tumors
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Summary:Background Most pituitary adenomas (PAs) are considered to have a soft tumor consistency. However, there is a non-negligible percentage (5–13%) of tumors presenting or exhibiting a fibrous consistency that would entail a more difficult and complicated surgical excision with higher surgical morbidity and mortality rates. Purpose To analyze the clinical consequences of PA tumor consistency on the surgical outcomes in patients undergoing endonasal endoscopic transsphenoidal (EET) pituitary surgery. Methods An ambispective study of patients with PAs operated on through an EET approach in two Spanish tertiary hospitals over the last 12 years. A total of 226 consecutive interventions were carried out in the Neurosurgery Departments of the Hospital Universitario Ramón y Cajal (HURC) and the Hospital Universitario Puerta del Sur by the same neurosurgeon. PAs were grouped into soft ( n  = 150) and fibrous ( n  = 76). All patients underwent hormonal and magnetic resonance imaging (MRI) studies before and after surgery. In addition, neurosurgical complications were recorded in each patient. Results Fibrous adenomas were independently associated with lower resection rates compared to soft adenomas (fibrous gross total resection [GTR] rate 48.7% vs. 76.3%, p  
ISSN:1559-0100
1355-008X
1559-0100
DOI:10.1007/s12020-022-03161-1