Controle hormonal dos adenomas hipofisários pela cirurgia transesfenoidal: Evolução dos resultados nos primeiros cinco anos de experiência

Abstract

Objective: To evaluate the initial results of a surgical team in the hormonal control of secreting pituitary adenomas. Materials and methods: In five years 51 functioning adenomas were operated (31 GH-secreting, 14 ACTH-secreting, 5 PRL-secreting and 1 TSH-secreting). Hormonal control was defined as GH ≤2,5 ng/mL, normal free-urinary cortisol, lower prolactin and normal T3 and FT4. Results: Control rates were 36% in acromegaly, and 57% in Cushing's disease. Two prolactinomas normalized prolactin levels. Thyroid hormone levels were normalized in the TSH--secreting adenoma. Control of hypercortisolism was positively correlated with years of experience (p = 0.01). Conclusion: Our results, although restricted to the beginning of our experience, lie below the reported range of other surgical series with much longer experience. During these years, there was a significant improvement in initial post surgery urinary cortisol levels in Cushing's disease as a function of surgical experience.