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Acromegaly. Treatment by transsphenoidal microsurgery.
JAMA
|September 22, 1975
Summary
Transsphenoidal microsurgery effectively lowers growth hormone in acromegaly patients. This pituitary surgery also shows potential for preserving normal thyroid and adrenal function, offering a viable treatment option.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Acromegaly is a condition caused by excess growth hormone (GH).
- Transsphenoidal microsurgery is a common treatment for pituitary tumors causing acromegaly.
- Assessing surgical outcomes on GH levels and pituitary function is crucial.
Purpose of the Study:
- To evaluate the efficacy of transsphenoidal microsurgery in reducing serum GH levels.
- To assess the impact of surgery on preserved thyroid and adrenal function.
- To determine the suitability of this surgical approach for acromegaly treatment.
Main Methods:
- Serum GH, thyroid, and adrenal function tests were performed pre- and post-surgery.
- 16 acromegalic patients underwent transnasal transsphenoidal microsurgery.
- Follow-up ranged from 3 to 24 months.
Main Results:
- GH levels decreased to <5 ng/ml in 7/9 previously untreated patients, with preserved function in 8/9.
- In previously treated patients, GH levels decreased significantly, with variable preservation of thyroid and adrenal function.
- Post-surgery, 7 patients achieved GH levels <5 ng/ml, 3 achieved levels between 5-10 ng/ml.
Conclusions:
- Transsphenoidal microsurgery is effective in lowering GH levels in acromegaly.
- The procedure offers potential for preserving remaining pituitary function.
- It can be considered as an initial treatment for selected acromegaly patients requiring rapid disease control.
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