Transsphenoidal Surgery for Cushing's Disease: An Institutional Perspective of Follow-up and Monitoring of 59 Patients

摘要

Transsphenoidal surgery is the first choice treatment modality for ACTH pituitary adenomas. We retrospectively reviewed the 59 Cushing's disease patients (pts) diagnosed and operated at our institution between 1981 and 2003. Fifty eight pts were transsphenoidally operated, 8 underwent reoperations, because of surgical failure (6 pts) or recurren-ce (2 pts). The mean postoperative follow-up period was 10.2 + 4.8 years. Remission was achieved in 79.6 % of all (47 pts) after one operation and for 60% of the patients who underwent a second operation (5 pts). The long term recurrence rate was 3% (2 pts). After unsuccessful surgery 4 pts were submitted to conventional pituitary radiotherapy: 3 were cured and 1 developed radiation induced optic neuropathy. One pt was treated with a PPARg agonist rosiglitazone. Our series demonstrates the efficacy of transsphenoidal surgery for Cushing's disease.