Akademik Veri Yönetim Sistemi
EANS 2021, 3 - 07 Temmuz 2021, ss.76
Background: Transsphenoidal endoscopic surgery is the first-line treatment for
growth hormone-secreting adenomas. The aim of the study is to analyze the
results of transsphenoidal endoscopic approach for acromegaly and to determine
the predictive factors for remission.
Methods: A single-center retrospective review was performed in patients who
underwent endoscopic transsphenoidal surgery for acromegaly between January
2009 and January 2019. Demographic features, clinical presentation, histopathology
records, postoperative complications, pre- and postoperative radiologic,
and endocrinological assessments were evaluated. The factors that influence the
remission rates were investigated.
Results: A total of 73 patients were operated via transsphenoidal endoscopic
approach. Cavernous sinus invasion was detected in 32 (43,8%) patients and
57 (78%) patients had macroadenomas. Pathology specimens of the 27
(36,9%) patients revealed dual staining adenomas with prolactin. A total of
51 patients (69,8%) were in biochemical remission one year after surgery. A
second operation was performed in 10 patients (13,6%) with residual tumor
and without biochemical remission in the first year. 6 of these patients (60%)
were in remission at the last follow-up. Transient diabetes insipidus was
observed in 18 (24,6%) patients and rhinorrhea in 4 patients (5,4%) which
ceased with conservative treatment. None of the patients had developed
panhypopituitarism. The presence of cavernous sinus invasion, preoperative
IGF-1, immediate postoperative GH, and 3 rd -month IGF-1 levels are predictive
for remission.
Conclusion: Transsphenoidal endoscopic surgery is a safe and effective treatment
for acromegaly. Reoperation should be considered in patients with residual
tumor and without remission.