{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:32:42Z","timestamp":1792582362529,"version":"4.5.0"},"reference-count":68,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Regrowth of the lesion after surgical removal of pituitary adenomas is uncommon unless subtotal resection was originally achieved in the first surgery. Treatment for recurrent tumor can involve surgery or radiotherapy. Locations of residual tumor may vary based on the original approach. The authors evaluated the specific sites of residual or recurrent tumor after different transsphenoidal approaches and describe the surgical outcome of endoscopic endonasal transsphenoidal reoperation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors analyzed a prospectively collected database of a consecutive series of patients who had undergone endoscopic endonasal surgeries for residual or recurrent pituitary adenomas after an original transsphenoidal microscopic or endoscopic surgery. The site of the recurrent tumor and outcome after reoperation were noted and correlated with the primary surgical approach. The chi-square or Fisher exact test was used to compare categorical variables, and the Mann-Whitney U-test was used to compare continuous variables between surgical groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Forty-one patients underwent surgery for residual\/recurrent pituitary adenoma from 2004 to 2015 at Weill Cornell Medical College. The previous treatment was a transsphenoidal microscopic (n = 22) and endoscopic endonasal (n = 19) surgery. In 83.3% patients (n = 30\/36) there was postoperative residual tumor after the initial surgery. A residual tumor following endonasal endoscopic surgery was less common in the sphenoid sinus (10.5%; 2\/19) than it was after microscopic transsphenoidal surgery (72.7%; n =16\/22; p = 0.004). Gross-total resection (GTR) was achieved in 58.5%, and either GTR or near-total resection was achieved in 92.7%. Across all cases, the average extent of resection was 93.7%. The rate of GTR was lower in patients with Knosp-Steiner Grade 3\u20134 invasion (p &lt; 0.0005). Postoperative CSF leak was seen in only one case (2.4%), which stopped with lumbar drainage. Visual fields improved in 52.9% (n = 9\/17) of patients and were stable in 47% (n = 8\/17). Endocrine remission was achieved in 77.8% (n = 14\/18) of cases, 12 by surgery alone and 2 by adjuvant medical (n = 1) and radiation (n = 1) therapy. New diabetes insipidus occurred in 4.9% (n = 2\/41) of patients\u2014in one of whom an additional single anterior hormonal axis was compromised\u2014and 9.7% (n = 4\/41) of patients had a new anterior pituitary hormonal insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Endonasal endoscopic reoperation is extremely effective at removing recurrent or residual pituitary adenomas that remain after a prior surgery, and it may be preferable to radiation therapy particularly in symptomatic patients. Achievement of GTR is less common when lateral cavernous sinus invasion is present. The locations of residual\/recurrent tumor were more likely sphenoidal and parasellar following a prior microscopic transsphenoidal surgery and sellar following a prior endonasal endoscopic surgery.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.8.jns152709","type":"journal-article","created":{"date-parts":[[2016,10,28]],"date-time":"2016-10-28T13:59:39Z","timestamp":1477663179000},"page":"397-408","source":"Crossref","is-referenced-by-count":49,"title":["Reoperative endoscopic endonasal surgery for residual or recurrent pituitary adenomas"],"prefix":"10.3171","volume":"127","author":[{"given":"Hazem M.","family":"Negm","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Department of Neurosurgery, Menoufia University, Menoufia, Egypt;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafid","family":"Al-Mahfoudh","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"South East Neurosurgery and Spinal Surgery, Brighton and Sussex University Hospitals NHS Trust, East Sussex, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Pai","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Tata Main Hospital, Jamshedpur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harminder","family":"Singh","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salomon","family":"Cohen","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery, \u201cManuel Velasco Suarez,\u201d Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivashanmugam","family":"Dhandapani","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Otolaryngology, and"},{"name":"Neuroscience, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns152709","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"3411","DOI":"10.1210\/jcem.83.10.5111","article-title":"Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results","volume":"83","author":"Abosch A,","year":"1998","unstructured":"Abosch A, Tyrrell JB, Lamborn KR, Hannegan LT, Applebury CB, Wilson CB: Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results. 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