The Comparative Research On Microprolactinoma Treated With Transsphenoidal Surgery, Bromocriptine, And Gamma Knife

Objective: To discuss the effects of three different treatments, transsphenoidal microsurgery, bromocriptine and gamma knife, on pituitary microprolactinoma and to propose a standardized treatment project.Methods: 120 female patients (16~40y) with microprolactinoma were divide into three groups. Each group (n=40) accepted one of the upper mentioned treatments (transsphenoidal microsurgery, bromocriptine or gamma knife) respectively. Then we compared the effects of the three treatments by comparing the prolactin levels, healing rates, effective rates, recurrence rates, incidence of relative complications, therapeutic costs and satisfactory degrees of patients. Statistical analysis was performed at last. Results:1. The difference of prolactin levels in three groups was statistically significant (p <0. 001) in 1 month, 6 months, 24 months respectively. The difference of prolactin levels before treatment and after treatment was statistically significant too (p < 0.001) .2. The curative rates and effective rates among three groups were significantly different (p < 0. 001, p = 0. 001) .3. The difference of the recurrence rates among three groups were statistically significant (p < 0.001) .4. The incidence rates of relative complications among three groups were significantly different (p < 0.001) .5. The average therapeutic costs of the three groups were statistically significant (p < 0.001) .6. The average satisfactory degrees of the three groups were statistically significant(p< 0.001) . Conclusion: 1. All of the three treatments are effective on prolactinoma, while the effect ofmicrosurgery is the best. Bromocriptine and Gamma knife took the 2nd and the 3rd positions respectively according to their effects. In 1/3 of all the operations we found the pituitaries were surrounded by big tumors. We suppose that is one of the important reasons why the effect of gamma knife is not always satisfying in some cases.2. Transsphenoidal microsurgery is recommended to young patients who want to cure tumor as quickly as possible, patients who plan to bear children, or patients who are reluctant to take medicine for long time. Pharmaceutical therapy is recommended to patients who are older and willing to take medicine.3. We hesitate to recommend Gamma knife to patients with microprolactinoma. But we can consider Gamma knife when patients' symptom is visible and when patients are reluctant to accept transsphenoidal microsurgery or pharmaceutical therapy.