Endoscopic Transsphenoidal Surgery: Institutional Experience in Cushing's Disease

Introduction: We present the institutional experience performing fully endoscopic transsphenoidal approaches in patients with Cushing's disease from 2005 to 2012 at Hospital Universitario San Ignacio in Bogotá, Colombia.

Methods: Seven year's retrospective analysis of Transsphenoidal microsurgical treatment of Cushing's disease. The following report was made to assess symptoms, comorbidities and the outcome of surgical treatment with regard to remission rates and surgical complications.

Results: In seven years, twenty three cases were included for analysis. 85% of the patients were females. The most frequent comorbidities were diabetes (6 patients) and hypertension (3 patients). 83% of tumors were microadenomas. Disease free criteria were achieved in 61%. The remission rates were higher in patients with microadenomas (68%). Transient diabetes insipidus was the most frequent complication. None of them required permanent hormone replacement therapy.

Conclusions: Surgery is a very important part in the treatment of many patients with functioning pituitary adenomas. Endoscopic endonasal approaches have proven to be safe, which has made their use to be (more) widespread. Currently Transsphenoidal surgery is the first line treatment of Cushinǵs disease; however, the cure by surgery alone is improbable in invasive tumors with high secretory activity. Therefore it is required close monitoring of these patients to achieve favorable results.