Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly
- Authors
- Kim, Jung Hee; Hur, Kyu Yeon; Lee, Jung Hyun; Lee, Ji Hyun; Se, Young-Bem; Kim, Hey In; Lee, Seung Hoon; Nam, Do-Hyun; Kim, Seong Yeon; Kim, Kwang-Won; Kong, Doo-Sik; Kim, Yong Hwy
- Issue Date
- Aug-2017
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- Acromegaly; Endoscopic transsphenoidal surgery
- Citation
- WORLD NEUROSURGERY, v.104, pp.272 - 278
- Journal Title
- WORLD NEUROSURGERY
- Volume
- 104
- Start Page
- 272
- End Page
- 278
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/5870
- DOI
- 10.1016/j.wneu.2017.04.141
- ISSN
- 1878-8750
- Abstract
- OBJECTIVE: Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in 2 referral centers in Korea. METHODS: We enrolled 134 patients with acromegaly (microadenomas, n = 15; macroadenomas, n = 119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n = 74) and Samsung Medical Center (n = 60) between January 2009 and March 2016. Remission was defined as having a normal insulinlike growth factor-1 and a suppressed growth hormone (GH) < 1 ng/mL during an oral glucose tolerance test. RESULTS: Remission was achieved in 73.1% of patients, including 13 of 15 microadenoma patients (86.7%) and 86 of 119 macroadenoma patients (72.3%). A multivariate analysis to determine a predictor of biochemical remission demonstrated that absence of cavernous sinus invasion and immediate postoperative GH levels < 2.5 ng/dL were significant predictors of remission (adjusted odds ratio = OR], 5.14; 95% confidence interval = CI], 1.52e17.3 and OR, 9.60; 95% CI, 3.41e26.9, respectively). After surgery, normal pituitary function was maintained in 34 patients (25.4%). Sixty-four patients (47.7%) presented complete (n = 59, 44.0%) or incomplete (n = 5, 3.7%) recovery of pituitary function. Hypopituitarism persisted in 20 patients (14.9%) and worsened in 16 patients (11.9%). Postoperatively, transient diabetes insipidus was reported in 52 patients (38.8%) but only persisted in 2 patients (1.5%). Other postoperative complications were epistaxis (n = 2), cerebral fluid leakage (n = 4), infection (n = 1), and intracerebral hemorrhage (n = 1). CONCLUSIONS: Endoscopic transsphenoidal surgery for acromegaly presented high remission rates and a low incidence of endocrine deficits and complications. Regardless of surgical techniques, invasive pituitary tumors were associated with poor outcome.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - ETC > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/5870)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.