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Titolo:
Recovery of hypopituitarism after neurosurgical treatment of pituitary adenomas
Autore:
Webb, SM; Rigla, M; Wagner, A; Oliver, B; Bartumeus, F;
Indirizzi:
Autonomous Univ Barcelona, Hosp St Pau, Dept Endocrinol, Barcelona 08025, Spain Autonomous Univ Barcelona Barcelona Spain 08025 , Barcelona 08025, Spain Autonomous Univ Barcelona, Hosp St Pau, Dept Neurosurg, Barcelona 08025, Spain Autonomous Univ Barcelona Barcelona Spain 08025 , Barcelona 08025, Spain
Titolo Testata:
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
fascicolo: 10, volume: 84, anno: 1999,
pagine: 3696 - 3700
SICI:
0021-972X(199910)84:10<3696:ROHANT>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSSPHENOIDAL SURGERY; ACROMEGALIC PATIENTS; MICROSURGERY; THYROTROPIN; CURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Webb, SM Autonomous Univ Barcelona, Hosp St Pau, Dept Endocrinol, Pare Claret 167, Barcelona 08025, Spain Autonomous Univ Barcelona Pare Claret 167 Barcelona Spain 08025
Citazione:
S.M. Webb et al., "Recovery of hypopituitarism after neurosurgical treatment of pituitary adenomas", J CLIN END, 84(10), 1999, pp. 3696-3700

Abstract

Surgery is the treatment of choice for many pituitary tumors; pituitary function may suffer after operation, but relief of pressure on the normal pituitary may also favor postoperative recovery of hypopituitarism. The aim ofthis study was to investigate the frequency of new appearance and recoveryof hypopituitarism after neurosurgery and try to identify features associated with it. Pre- and postoperative anterior pituitary functions were investigated in 234 patients with pituitary adenomas (56 nonfunctioning, 71 PRL-secreting, 66 GH-secreting, 39 ACTH-secreting, 1 LH/FSH-secreting, and 1 TSH-secreting tumor). Eighty-eight new postoperative pituitary hypofunctions appeared in 52 patients (12 NF, 14 PRL-secreting, 15 GH-secreting, 10 ACTH-secreting, and 1 LW/FSH-secreting adenomas). They corresponded to 27% ACTH deficiencies tin 29 of the 107 patients with normal preoperative ACTH in whom postoperative evaluation was complete!, 14.5% (15 of 103) new GH deficiencies, 10.5% (15 of 143; P < 0.0005, significantly less than ACTH deficiency) new TSH deficiencies, 16.5% (20 of 121) new gonadotropin deficiencies, and 13% (9 of 71) new PRL deficiencies. Preoperatively, 93 were deficient inat least 1 pituitary hormone; after surgery, 45 (48%) recovered between 1 and 3 hormones. The 2 patients with LH/FSH- and TSH-secreting macroadenomasdid not recover pituitary function. Factors associated with a higher probability of postoperative pituitary function recovery were: no tumor rests onpostoperative pituitary imaging (P = 0.001) and no neurosurgical (P = 0.001) or pathological evidence (P = 0.049) of an invasive nature. Tumor size did not differ significantly between those who did and those who did not recover pituitary function after surgery. Even if clear hypofunction is observed at initial work-up, patients shouldbe reassessed after surgery without substitution therapy, because practically half the preoperative pituitary hormone deficiencies recover postoperatively, eliminating the need for life-long substitution therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 01:48:08