The reasons of death and group of risk in pituitary surgery

Grigoriev A., Kadashev B., Kalinin P.

The 7-th Fsian-Oceanian International Congress on Skull Base Surgery. April 15-18, 2004, Taipei, Taiwan. Abstracts.P. 109-110

Materials and metods: What group of patients is subject to the greatest risk at removal of pituitary adenomas?

For the period with 1988 on 1997 we operated 2171 patients with pituitary adenomas. From them the first time was operated 1981 patient. Operations concerning relapse of a tumour were made by 249 patient.


Comparing results of surgical treatment it is obvious, that the best results are given transsphenoidal surgery: mortality was 1,9% (24 from 1231 patients); after transcranial surgery mortality was 6,3% (47 from 750 patients).

The greatest mortality in group of patients was more senior than 60 years — 7,5 %, in group of patients with expressed invasion a tumour in the basis of a skull — 22,7 %, in group of patients with huge adenomas (> 60 mm) — 20,2 %.

Tumours at 17% of patients are in part removed, the others — is total.

Principal causes of death of patients were infringements of brain blood circulation on haemorragic type at 12 patients (16,9 %), infringements of brain blood circulation on ischemic type at 9 (12,7 %), on mixed at 11 (15,5 %), meningitises at 13 (18,3 %), somatic problems at 8 (11,3 %) etc. At comparison from series of operations for 1978 — 1988 the quantity haemorragic complications from 50,9 % up to 16,9 % has decreased and ischemic the quantity has increased from 5,5 % up to 12,7 %. It is connected to increase of radicalism of removal of adenomas for last years.


The greatest mortality was in groups of patients of advanced age with huge adenomas of a hypophysis. The most often reason of lethal outcomes were infringements of brain blood circulation on haemorragic to type and meningitises.

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