Transsphenoidal microsurgery of pituitary macroadenomas with long-term follow-up results

J Neurosurg. 1983 Sep;59(3):395-401. doi: 10.3171/jns.1983.59.3.0395.


The authors have reported on 108 patients with pituitary macroadenomas (measuring 2 cm in at least one diameter) who underwent 117 transsphenoidal operations and five craniotomies, and were followed for periods ranging from 6 months to 14 years. Vision improved in 90% of the patients. Gross total tumor removal with no evidence of residual tumor tissue demonstrable on the postoperative computerized tomography scan was accomplished in 41% of cases. However, gross total tumor removal is not synonymous with complete tumor removal. Endocrine cure was possible in 25% of prolactin-secreting and 20% of growth hormone-secreting adenomas. The incidence of recurrence was 12%, with the majority occurring from 4 to 8 years postoperatively. Both the tumors with suprasellar extension of more than 2 cm and the hard fibrotic tumors had a higher recurrence rate. Postoperative administration of radiation therapy has been associated with a significantly lower recurrence rate than when this therapy was withheld. Transsphenoidal surgery of pituitary macroadenomas confined to the extra-arachnoid space is associated with a relatively small number of complications. The operative technique used in this series is described.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / pathology
  • Adenoma / surgery*
  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / classification
  • Outcome and Process Assessment, Health Care
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / pathology
  • Pituitary Neoplasms / surgery*
  • Sphenoid Sinus / surgery*
  • Time Factors
  • Tomography, X-Ray Computed
  • Visual Acuity