The first 100 transsphenoidally operated pituitary adenomas in a non-specialised centre: surgical results and tumour-recurrence.

From 118 transsphenoidally operated patients, 100 had a pituitary adenoma; 33 prolactinomas, 20 HGH-producing, 2 ACTH-producing and 45 inactive adenomas. The first transsphenoidal operation did not cause any mortality; after reoperation for suspected recurrence on follow-up, 2 patients died; thus, the global management mortality was 1.8%. As surgical complications, diabetes insipidus occurred in 5%, hypopituitarism in 4%. Age at operation was significantly higher in female patients with micro- than with macroprolactinomas, and also markedly higher in men than in women with prolactinomas. Preoperative serum prolactin levels were related to tumour size and age and demonstrated an important prognostic factor of postoperative cure. The prognosis of preoperative visual field defects was dependent on preoperative duration. During a follow-up period of 1-6.3 years, 7 patients were reoperated for recurrence of their tumour after intervals of 2-4.5 years; 6 of these patients had had inactive macroadenomas, 1 an ACTH-producing macroadenoma. In 3 of these patients, radiation therapy had been performed. The highest recurrence-rate (19%) among 100 patients was found in patients with inactive macroadenomas with a follow-up of more than 2 years.