Abstract】Objective: To analyze the efficacy of transsphenoidal surgery for pituitary prolactin microadenoma, and to provide more reasonable and scientific guidance for clinical treatment selection and prognostic evaluation of pituitary prolactin microadenoma.
METHODS: We retrospectively analyzed the surgical efficacy of 102 cases of pituitary prolactin microadenoma treated by transsphenoidal surgery in our department in the past 10 years and analyzed the factors affecting the surgical efficacy. There were 2 males and 100 females in this group, aged (30.9±7.1) years; preoperative disease duration (51.0±45.7) months; preoperative PRL value (226.7±51.0) ng/ml; 98 cases with first symptoms of amenorrhea, lactation and/or infertility. All cases were treated with transsphenoidal surgery. Postoperative follow-up was (43.9±36.2) months.
RESULTS: There was no operative mortality. There were 53 cases of transient water and electrolyte disorders after surgery, and one case of residual hypothyroidism. Eighty-five cases (83.3%) were cured, 3 cases (2.9%) were in remission, 6 cases (5.9%) were progressing, and 8 cases (7.8%) were not effective. There was no significant effect of preoperative disease duration, PRL level, preoperative bromocriptan or not, tumor texture, whether the tumor was stroked or not, and the degree of intraoperative saddle diaphragm descent on the efficacy of transsphenoidal surgery for pituitary prolactin microadenoma. The total cost of transsphenoidal surgery was ($13,135.0±2417.4).
CONCLUSION: For pituitary prolactin microadenoma, transsphenoidal surgical treatment can achieve the same therapeutic results as with pharmacological treatment such as dopamine agonists, which may be long-term and radical. Both in terms of treatment efficacy, patient convenience, rebuilding confidence for the patient and treatment cost, transsphenoidal surgical treatment can be the treatment of choice for pituitary prolactin microadenoma.