Follow-up of transsphenoidal surgery for secreting pituitary adenomas

Objective:To study the effectiveness of transsphenoidal surgery for GH ,ACTH ,and PRL secreting pituitary adenomas.Methods:Among 254 patients with diagnosed pituitary adenomas from Oct.1995 to Sep.2002,143 cases of secreting pituitary adenomas(56.3%) had the full endocrinological testing and MRI follow up information (61 PRL ,50 GH ,32 ACTH ).The median follow up time was 2.3 years.Results:The total removal rate for PRL secreting adenomas (34.4%) was significantly lower than that for GH (68.0%) and ACTH secreting (78.1%) adenomas( P 0.01).Total removal rate was correlated with tumor size and invasiveness:that of microadenomas was higher than macroadenomas( P 0.05) and that of noninvasive adenomas was higher than invasive adenomas( P 0.05).The recurrence rate of PRL secreting adenomas was higher than that of ACTH and GH secreting adenomas ( P 0.05); that of invasive adenomas was higher than noninvasive adenomas( P 0.05).Hormonal level in secreting pituitary adenomas had an overall decrease postoperatively.Conclusion:The therapeutic effects of GH and ACTH secreting pituitary adenomas are better than that of PRL secreting adenomas.The therapeutic effects of secreting pituitary adenomas are related to their endocrinological feature and invasiveness.