AN ANALYSIS OF THE EFFECT OF TRANSSPHENOIDAL PITUITARY MICROSURGERY FOR CUSHING DISEASE / 中华内分泌代谢杂志

ABSTRACT

From the beginning of 1980 to the end of 1992, 125 patients with Cushing disease were undergone transsphenoidal microsurgery. 41 patients were operated by selective adenoma resection and 62 patients by radical surgery. 103 cases were available to be analyzed. The results of a long-term follow-up showed (1) The cure rates were 63. 1% and 48.1% with positive and negative pathological study, respectively. (2) The cure rates were 72.6% and 41. 5% with radical and selective surgery respectively. In cured patients the plasma cortisol level dropped to normal or subnormal within 48 hours after the surgery. However, in uncured patients, it was still above the normal. After operation, 1. 6% of cases (1/60) had secondary hypothyroidism and 62.5 % of cases (30/48) who had abnormal menstruation preoperatively restored normal menstrual cycle. The recurrent rate was 11.4%. Conclusion: (1) The outcome of radical surgery is better than the selective adenoma resection; (2) The pathological study and the analysis of the plasma cortisol level within 48 hours after the surgery may have predictive value for efficacy of the surgery.