Pituitary neuroendocrine tumours (PitNETs) are among the most common tumours of the central nervous system, yet data regarding surgical outcomes is limited for New Zealand (NZ). This study presents a 23-year single-surgeon case series of pituitary surgery. A retrospective analysis of 1,224 pituitary operations performed between August 1999 and July 2023 was conducted. Patient demographics, tumour characteristics, complications, and long-term outcomes were analysed. Statistical analyses included univariate and multivariate models. Pituitary neuroendocrine tumours (PitNETs) accounted for 88 % of cases (n = 1,087), including 612 non-functioning, 175 GH-producing, and 112 ACTH-producing tumours. The complications of transsphenoidal surgery for PitNETs included postoperative cerebrospinal fluid (CSF) leaks (7.3 %), permanent diabetes insipidus (3.4 %), meningitis (2.4 %), and visual deterioration (1.2 %). Carotid injury, stroke, and death within 30 days each occurred in less than 1 % of cases. Among 554 non-functioning PitNETs with surveillance imaging, 20 % recurred after a median follow-up of 3.7 years (IQR 1.6-7.7), with 10 % requiring reoperation. Recurrence was detected in 60 % of cases by five years and 90 % by ten years, of those who recurred. Age was protective, with each additional year reducing risk (HR = 0.98, p = 0.005). Cavernous invasion strongly predicted recurrence (HR = 2.9, p < 0.001). No significant association between ethnicity and recurrence was observed, including among Māori and Pasifika patients. Surgical remission in acromegaly was achieved in 76 % of microadenomas (median follow-up: 4.8 years; IQR: 1.0-6.8) and 75 % of macroadenomas (median follow-up: 4.3 years; IQR: 1.5-8.5). In Cushing's disease, remission was achieved in 82 % of microadenomas (median follow-up: 3.1 years; IQR: 0.8-9.2) and 75 % of macroadenomas (median follow-up: 4.0 years; IQR: 0.6-8.7). These findings demonstrate postoperative outcomes, complication rates, hormonal improvement, and tumour control, comparable to international standards.

Keywords: Acromegaly; Cushing’s disease; Non-functioning adenoma; Pituitary gland; Pituitary neoplasms; Pituitary neuroendocrine tumour; Transsphenoidal surgery.

Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.

垂体神经内分泌肿瘤（PitNETs）是中枢神经系统中最常见的肿瘤之一，然而关于新西兰（NZ）外科手术结果的数据却非常有限。本研究提供了一位医生23年的单中心垂体手术病例系列。该回顾性分析涵盖了1999年8月至2023年7月期间进行的1,224例垂体手术。对患者的临床特征、肿瘤特点、并发症及长期结果进行了分析，统计方法包括单变量和多变量模型。 垂体神经内分泌肿瘤（PitNETs）占病例总数的88%（n = 1,087），其中包括612例非功能性肿瘤、175例生长激素（GH）产生型肿瘤以及112例促肾上腺皮质激素（ACTH）产生型肿瘤。经蝶窦手术治疗PitNETs的并发症包括术后脑脊液漏（7.3%）、永久性尿崩症（3.4%）、脑膜炎（2.4%）和视力恶化（1.2%）。颈内动脉损伤、中风以及30天内的死亡率均低于1%。 在554例非功能性PitNETs的随访影像学检查中，有20%的病例在平均随访期为3.7年（IQR 1.6-7.7）时复发，其中10%需要再次手术。五年内复发的患者中有60%，十年内复发的患者中有90%被发现复发。年龄具有保护作用，每增加一岁复发风险降低（HR = 0.98, p = 0.005）。海绵窦侵袭强烈预示着复发（HR = 2.9, p

关键词：肢端肥大症；库欣病；非功能性腺瘤；垂体；垂体神经内分泌肿瘤；经蝶窦手术。

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