With any surgery, there are certain risks. Pituitary tumor surgery is no exception, and one of the major risks of surgery is damage to pituitary function.
Injury is inevitable and can be replaced by hormones. Similar to the “surgical” precision strikes in the U.S. war on terror, even with a strong military, casualties are inevitable. Similarly, doctors try to be “perfect” when performing pituitary tumor surgery, but in some cases it is difficult to avoid the loss of some normal pituitary tissue, especially when the surgery is difficult and the tumor is removed to encircle the cavernous sinus and major blood vessels. Even with experienced pituitary tumor surgeons, approximately 5-10% of patients still experience postoperative hypopituitarism after removal of large pituitary adenomas.
The damage is usually irreparable once it has occurred and some patients may require long-term hormone replacement therapy, including thyroid hormone, corticosteroids, growth hormone, estrogen, or testosterone.
Function can be partially restored without lifelong replacement therapy After surgery, patients may experience “injury” to the pituitary gland. For example, damage to the posterior pituitary gland can cause uremia (1-2% incidence), which is due to the inability to reabsorb the body fluid filtered by the kidneys and the large amount excreted from the body. Patients produce urine that is as colorless and clear as clear water, and also experience frequent urination and irritable thirst. These symptoms can be treated with synthetic antidiuretic hormone (i.e., mydriasis) replacement therapy, which is more effective.
In most patients, pituitary function can be partially restored after the surgical trauma and inflammation have subsided, and long-term drug supplementation is not required. In addition, in most patients, after most of the anterior pituitary tissue has been removed, the remaining anterior pituitary tissue is still able to secrete enough hormones for normal body activities, so surgical injury does not mean that lifelong replacement therapy is required.
In conclusion, with the popularization and improvement of microsurgical techniques, the proportion of pituitary function damage caused by surgery is becoming less and less severe, and most patients can gradually recover pituitary function after surgery without the need for lifelong medication.