Pure endoscopic transsphenoidal surgery for treatment of acromegaly: results of 67 cases treated in a pituitary center

dc.creatorGondim, JA
dc.creatorAlmeida, JP
dc.creatorde Albuquerque, LAF
dc.creatorGomes, E
dc.creatorSchops, M
dc.creatorFerraz, T
dc.date2010
dc.dateOCT
dc.date2014-11-16T19:33:13Z
dc.date2015-11-26T17:26:24Z
dc.date2014-11-16T19:33:13Z
dc.date2015-11-26T17:26:24Z
dc.date.accessioned2018-03-29T00:13:36Z
dc.date.available2018-03-29T00:13:36Z
dc.identifierNeurosurgical Focus. Amer Assoc Neurological Surgeons, v. 29, n. 4, 2010.
dc.identifier1092-0684
dc.identifierWOS:000283802600008
dc.identifier10.3171/2010.7.FOCUS10167
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/58434
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/58434
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/58434
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1284553
dc.descriptionObject. Acromegaly is a chronic disease related to the excess of growth hormone (GH) and insulin-like growth factor-I secretion, usually by pituitary adenomas. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The introduction of endoscopy as an additional tool for surgical treatment of pituitary adenomas and, therefore, acromegaly represents an important advance of pituitary surgery in the recent years. The aim of this retrospective study is to evaluate the results of pure transsphenoidal endoscopic surgery in a series of patients with acromegaly who were operated on by a pituitary specialist surgeon. The authors discuss the advantages, outcome, complications, and factors related to the success of the endoscopic approach in cases of GH-secreting adenomas. Methods. The authors retrospectively analyzed data from cases involving patients with GH-secreting adenomas who underwent pure transsphenoidal endoscopic surgery at the Department of Neurosurgery of the General Hospital in Fortaleza, Brazil, between 2000 and 2009. Tumors were classified according to size as micro-or macroadenomas, and tumor extension was analyzed based on suprasellar/parasellar extension and sella floor destruction. All patients were followed up for at least 1 year. The criteria of disease control were GH levels < 1 ng/L after oral glucose tolerance test and normal insulin-like growth factor-I levels for age and sex. Results. During the study period, 67 patients underwent pure endoscopic transsphenoidal surgery for treatment of acromegaly. Disease control was obtained in 50 cases (74.6%). The rate of treatment success was higher in patients with microadenomas (disease control achieved in 12 [85.7%] of 14 cases) than in those with larger lesions. Suprasellar/parasellar extension and high levels of sella floor erosion were associated with lower rates of disease control (p = 0.01 and p = 0.02, respectively). Complications related to the endoscopic surgery included epistaxis (6.0%), transitory diabetes insipidus (4.5%), and 1 case of seizure (1.5%). Conclusions. Endoscopic transsphenoidal surgery represents an effective option for treatment of patients with acromegaly. High disease control rates and a small number of complications are some of the most important points related to the technique. Factors related to the success of the endoscopic surgery are lesion size, suprasellar/parasellar extension, and the degree of sella floor erosion. Although presenting important advantages, there is no conclusive evidence that endoscopy is superior to microsurgery in treatment of GH-secreting adenomas. (DOI: 10.3171/2010.7.FOCUS10167)
dc.description29
dc.description4
dc.languageen
dc.publisherAmer Assoc Neurological Surgeons
dc.publisherRolling Meadows
dc.publisherEUA
dc.relationNeurosurgical Focus
dc.relationNeurosurg. Focus
dc.rightsfechado
dc.sourceWeb of Science
dc.subjectacromegaly
dc.subjectpituitary
dc.subjectadenoma
dc.subjecttransphenoidal surgery
dc.subjectendoscopic surgery
dc.subjectAdenomas
dc.subjectExperience
dc.subjectManagement
dc.subjectEra
dc.titlePure endoscopic transsphenoidal surgery for treatment of acromegaly: results of 67 cases treated in a pituitary center
dc.typeArtículos de revistas


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