Quality of Life and Work Capacity Are Unrelated to Approach or Complications After Pituitary Surgery

• Published in: World neurosurgery Vol. 108; pp. 24 - 32
• Main Authors: Uvelius, Erik, Castelo, Nazia, Kahlon, Babar, Svensson, Christer, Cervin, Anders, Höglund, Peter, Valdemarsson, Stig, Siesjö, Peter
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2017
• Subjects: Clinical Medicine; Health-related quality of life; Kirurgi; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Pituitary adenoma; Pituitary surgery; Surgery; Transsphenoidal surgery; Work capacity; Health-related quality of life; Transsphenoidal surgery; DI; VAS; HR; Pituitary surgery; IQR; KPS; QoL; Work capacity; Pituitary adenoma; CSF; pa-KPS
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.08.087

Endoscopic pituitary surgery has shown favorable clinical outcomes. Less is known about the impact of surgical approaches on health-related quality of life (HRQoL) and work capacity. The present study was undertaken to compare transsphenoidal microscope-assisted surgery with endoscopic transsphenoidal surgery regarding preoperative and surgical factors for the final outcome of HRQoL and work capacity. In a retrospective study of patients operated on for pituitary adenoma, outcome was compared between those operated on before and after transition with endoscopic surgery at our department. Data were gathered via patient questionnaires and patients' files. After exclusions, 235 patients were included (99 microsurgical and 136 endoscopic). Frequency of complications was similar but tumor size was significantly larger in the endoscopic group. Complications did not affect HRQoL or work capacity. HRQoL was not affected by surgical technique but showed an overall trend toward lower values compared with the general population. Sick leave, return to work frequency, and permanent sick leave were not affected by surgical technique. Female gender was a factor for lower ratings in all outcome variables. Surgical technique does not influence HRQoL or work capacity in this long-term follow-up although both are decreased compared with the general population. We conclude that fully endoscopic pituitary surgery, despite including larger tumors, bears the same risk for complications as microsurgery. In addition, females have a greater risk for decrease in HRQoL and work ability. This factor should be taken into account when informing patients and appreciating expectations of treatment.