2005, Number 1
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Med Int Mex 2005; 21 (1)
Acromegaly: remission following surgical intervention
Cabello UNA, Cárdenas ESA, Oliveros RA, Tamez PHE, González MPM
Language: Spanish
References: 26
Page: 32-43
PDF size: 58.54 Kb.
ABSTRACT
Background: Acromegaly is a disorder of somatic growth, its prevalence ranges from 40 to 60 cases per million. Growth hormone secreting pituitary adenoma causes 99% of the cases.
Objective: To describe the results of the transsphenoidal surgery as initial treatment of growth hormone secreting pituitary adenoma, in 46 acromegalic patients.
Material and methods: We retrospectively analyzed the results of transsphenoidal surgery (performed by 11 surgeons) as initial therapy for GH-secreting pituitary adenomas in 46 acromegalic patients. As remission criteria, we used a postoperative random GH level of ‹ 5 ng/mL, there were no clinical symptoms and no subsequent therapy.
Results:/ After surgery, 14 patients (30.4%) achieved remission, 58.3% of the patients with microadenomas and 20.5% of the patients with macroadenomas. Remission rate was also related to preoperative GH levels. The incidence of major postoperative complications was of 15.2%, without perioperative deaths.
Conclusions: Our results are lower than those from published series, but confirm that surgery provides an adequate initial treatment for GH-secreting pituitary adenomas, which depend on experience gained from total hypophysectomy, size and extrasellar growth of the tumor, and preoperative GH level. We need to improve our results and follow collaborative guidelines of study and treatment for these patients, at the endocrinology and neurosurgery services, and to limit the number of surgeons to gain great experience.
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