pituitary tumor surgery complications

What are the warning signs that there are complications following pituitary surgery to remove a macroadenoma?  What steps are taken to treat the complication such as high blood pressure or extensive pain?

If the complication results in blindness, is it temporary?

Your help with these questions is appreciated.

[Caliber2005]

Hi,
What approach they are planning for tumor resection?
Why are they planning surgery for tumor removal? Have they exhausted all conservative and radiation therapy? Are there any complications developed because of pituitary tumor?
The extent and approach of surgery depends on complications and size of tumor.
Bye.

[Caliber2005]

Hi,
There are complications associated with surgery depending upon approach.
Most pituitary tumors can be removed transsphenoidally. The approach is through the sphenoid sinus, one of the facial air spaces behind the nose. Rarely, a craniotomy is required, where the skull is opened to reach the tumor. There are three basic approaches to the sella, which is the bony cavity in the skull base where the pituitary gland is located.
It has been shown that the success of surgery is dependent on the amount of experience the surgeon has at performing pituitary operations. Surgeons with the most experience generally have the highest rates of cure, meaning complete tumor removal. In addition, the rate of complications is lowest among experienced pituitary surgeons.
There are some complications like new hormone replacement might be required after the surgery, possibly including thyroid hormone, cortisol, growth hormone, estrogen or testosterone. Damage to the posterior or back portion, of the pituitary gland may produce a condition known as diabetes insipidus, which will lead to frequent urination and excessive thirst, since the kidneys will no longer adequately concentrate the urine. This can be controlled with a nasal spray or pill form of a medication called DDAVP. Permanent diabetes insipidus occurs 1-2% of the time after pituitary surgery.
There is a very small chance of damaging the carotid arteries which are located on either side of the pituitary.
There could also be post-operative bleeding into any residual tumor or into the sella, which could lead to worsening pressure on the optic nerves or chiasm and could possible visual loss.
A spinal fluid leak sometimes occurs because pituitary tumors are separated from the spinal fluid which bathes the brain by a very thin membrane.
If the complications results in blindness which is due to some clot, then it could be reversed up on immediate surgery.
Hope this helps.
Bye.

[teamgabs]

Thank you this helps.  The surgery is through the mouth up the nasal cavity.  After the surgery is there any particular warning signs that would indicate that something didn't quite go right?  How soon after surgery would these signs show?

[Caliber2005]

Hi,
Most of the signs and symptoms would be evident after 24 hours but within 48 hour's. Maximum time with 7 days most of the sign and symptoms would be apparent, but some can take long time to appear.
Bye.

[Pitsufferer]

I had my pituitory tumor surgery done three weeks ago. My prolactin levels suppose to go down after the surgery got tripled from the level before the surgery. Three weeks after the surgery my prolactin levels are still high around 260. Anybody has anything to share with me.
Thanks

[computervenkat]

my father have pituitary Macroedenoma in the age 70 the size is 4cmX5cm what is the position on surgery?