gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Pituitary surgery in the elderly: A prospective clinical comparison with younger patients

Hypophysenchirurgie bei geriatrischen Patienten: ein prospektiver klinischer Vergleich mit jüngeren Patienten

Meeting Abstract

Suche in Medline nach

  • corresponding author Claudius Thomé - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim
  • H. Bode - V. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.02.01

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Veröffentlicht: 23. April 2004

© 2004 Thomé et al.
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With an increasing proportion of the elderly in the population, surgical treatment of this age group becomes more important and is thought to be complicated by increased rates of perioperative morbidity. The objective of this study was to compare the clinical characteristics of elderly patients with pituitary lesions and the safety of the surgical procedure with younger patients.


During a 5-year period from 1998 to 2003 surgical procedures of the pituitary were prospectively analysed for perioperative complications. 36 of 123 adult patients were older than 70 years (29.3%; 76±5 years). Clinical presentation, histological diagnosis, perioperative morbidity and reoperations were assessed in addition to other parameters and statistically compared between the age groups. Follow-up was conducted via the neurosurgical and endocrinological outpatient clinic.


Chiasmatic syndrome was present in 61.1% of elderly patients vs. 35.6% in patients younger than 70 years (p<0.05) corresponding to a higher rate of non-functioning pituitary adenomas (75.0% vs. 50.6%; p<0.05). Acromegaly and ACTHomas were present in 2.8% and 13.9% (>70yrs) vs. 16.1% and 10.3% of patients (<70yrs; n.s.). Other pathologies (Rathke cleft cysts, metastasis, etc.) were more common in younger patients resulting in more transcranial operations (9.2% vs. 2.8%) in this age group. Duration of transsphenoidal surgery did not differ between the groups. There was no perioperative mortality, but 4 reoperations due to CSF fistula or intrasellar hemorrhage were performed in patients over 70 years (11.1%) vs. 2 reoperations in younger patients (2.3%; p=0.1).


Elderly patients with pituitary lesions mostly present with non-functioning adenomas and chiasmatic syndrome. Surgery usually via the transsphenoidal route can be safely performed although perioperative morbidity is somewhat increased in comparison to younger patients. Special attention should be paid to the risk of hemorrhage after subtotal removal of large suprasellar lesions particularly in the elderly.