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ALTERATION OF PROLACTIN SECRETION AFTER TRANSSPHENOIDAL ADENOMECTOMY FOR PROLACTINOMAS Motoharu Yokoyama 1,2 1Department of Neurosurgery, Brain Research Institute, Niigata University Keyword: prolactinoma , transsphenoidal surgery , recurrence pp.773-779
Published Date 1990/8/1
DOI https://doi.org/10.11477/mf.1406900089
  • Abstract
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The author studied the dynamics of prolactin (PRL) secretion after adenomectomy, and considered the treatment for prolactinomas. The study group comprised a total of 74 patients with prolactinomas who underwent transsphenoidal surgery between 1979 and 1986, and 61 patients out of them were followed up more than one year. Post-operatively, hyperprolactinemia was cured (under 20 ng/ml) in 19 of 36 microadenomas (53%), and 7 of 38 macro-adenomas (18%). Pre-operatively, PRL response to TRH was blunt except 3 patients, but it reco-vered in 16 patients after surgery, and 5 more pa-tients during follow-up. Recurrence of hyperpro-lactinemia occured in only one of 19 patients who were followed up more than one year, and she was not a PRL responder to TRH. Bromocriptine was administrated to 46 patients after surgery, and hyperprolactinemia was restored to normal in 40 patients. And in 7 patients whose basal PRL le-vels were between 23 and 41 ng/ml after surgery, hyperprolactinemia was cured still after withdra-wal of bromocriptine. During pregnancy, PRL le-vels were relatively low in surgically cured pati-ents, but in most of others, they became over 200 ng/ml promptly after withdrawal of bromocriptine.

Recurrence of hyperprolactinemia was rare, and PRL response to TRH recovered in most of surgi-cally cured patients. Even if it is not cured sur-gically, lowered PRL levels have a good effect on the additional bromocriptine therapy. I prefer transsphenoidal surgery in respect of curative tre-atment for prolactinomas.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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