Repeat endoscopic endonasal transsphenoidal surgery for residual or recurrent Cushing’s disease: safety, feasibility, and success
Authors' conclusion
Repeat ETS is a safe and effective treatment option for residual or recurrent CD with satisfactory remission rates and low rates of complications.
Study context
- Population
- Patients with residual or recurrent Cushing's disease (CD) who underwent repeat endoscopic transsphenoidal surgery (ETS), January 2006–December 202065 repeat ETS
- Participants
- 56 patients
- Outcome
- Remission
Methodological detailssingle neurosurgeon
- Single neurosurgeon
Main finding
As reported in the abstract
- Remission after first repeat ETS
- 47 (83.9%) patients
- Additional remission after second repeat procedure
- 9 (16.1%)
- Sustained remission
- 48 patients (85.7%)
- Sustained remission after first repeat ETS
- 44
- Sustained remission after second repeat ETS
- 4
- Recurrence rate post repeat surgery
- 6.38%
Observational data: associations, not effects.
Further findings
Prior surgery
- Previous microscopic surgery
- 40 (61.5%)
- Prior endoscopic procedures
- 25 (38.5%)
Predictor of sustained remission (logistic regression) · postoperative day 1
- Serum cortisol >5 µg/dL associated with reduced likelihood of sustained remission
Safety
Complications
- Transient diabetes insipidus (DI)
- 5 (7.6%) patients
- Permanent DI
- 2 (3%) patients
- Panhypopituitarism
- one case (1.5%)
- Rhinorrhea necessitating reoperation
- Three patients (4.6%)
Original publication
Repeat endoscopic endonasal transsphenoidal surgery for residual or recurrent Cushing’s disease: safety, feasibility, and success. Pituitary. Published 15 May 2024. doi:10.
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