@misc{10481/103701,
year = {2025},
month = {2},
url = {https://hdl.handle.net/10481/103701},
abstract = {Background: The outcomes of transsphenoidal surgery (TSS) for pituitary
adenoma (PA) depend on many factors, including the availability of an expert
team and the volume of surgeries performed. Data on the outcomes of TSS for
PA are scarce in our country. TESSPAIN evaluates TSS outcomes in Spanish
centers to assess the influence of surgical volume and specialized neurosurgical
teams on success and complication rates.
Methods: A retrospective, nationwide, study of Spanish centers performing TSS
between January 2018 and December 2022. Centers were classified as high
volume (HV) [n=11, defined as centers with recognized expertise in Spain or those
performing more than 25 TSS/year] or non-HV. Data collection included surgical
success rates, complications, and pituitary adenoma resectability (R-PA).
Additional analyses evaluated the impact of dedicated neurosurgical teams
(DNT) within HV centers.
Results: A total of 2815 TSS from 29 Spanish centers were included (1421 NSPA,
436 GH-secreting, 323 Cushing’s disease, 127 PRL-secreting and 25 TSH-secreting
PA). The overall success rate was 50.5%, 76.8% for R-PA. HV centers had a higher
overall success rate (53.1 vs. 47.7%; p=0.03). Better TSS outcomes for NSPA
accounted for this difference. The overall TSS complication rate was 22.1%,
which was higher for NSPA than for SPA (25.0 vs. 17.7%). The overall
complication rate of TSS for PA was significantly higher in non-HV centers than
in HV centers (24 vs 20.4.0; p <0.01). Centers with a DNT showed a trend to higher
success rate in R-PA, while having a lower overall incidence of complications in
TSS for PA than HV centers without a DNT (18.5 vs. 23.0; p=0.058), mainly reducing
the rate of permanent ADH deficiency in all TSS for PA (2.7 vs. 8.4%; p<0.001).
Conclusion: Higher surgical volume and DNT are associated with improved TSS
outcomes for PA in Spain. Our results support the recommendation of
concentration of pituitary surgery in a reduced number of centers of expertise
in our country in order to improve the success rate and reduce complications,
mainly postoperative ADH deficiency.},
organization = {Spanish Society of Endocrinology and Nutrition},
publisher = {Frontiers Media},
keywords = {Transsphenoidal surgery},
keywords = {Pituitary adenoma},
keywords = {Surgical complications},
keywords = {Success rate},
keywords = {Surgical experience},
title = {Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study},
doi = {10.3389/fendo.2025.1529418},
author = {Paja Fano, Miguel and Novo, Cristina and Ortiz, Isabel and Tenorio-Jiménez, Carmen and Neuroendocrinology Group},
}