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Updated: Dec 16, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Surgery for Acromegaly.

Sauradeep Sarkar1, Ari G Chacko1

  • 1Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.

Neurology India
|July 3, 2020
PubMed
Summary
This summary is machine-generated.

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Transsphenoidal surgery is the primary treatment for acromegaly, a disorder caused by excess growth hormone (GH). While surgery offers good outcomes, achieving remission depends on tumor characteristics, and further management is needed for persistent disease.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Acromegaly, caused by growth hormone (GH) hypersecretion from pituitary adenomas, presents significant perioperative and long-term management challenges.
  • Strict biochemical remission criteria necessitate aggressive treatment strategies for this complex endocrinological disorder.

Purpose of the Study:

  • To review the surgical management of acromegaly, focusing on contemporary outcomes and treatment controversies.
  • To summarize current evidence on the efficacy and challenges of surgical interventions for GH-secreting pituitary adenomas.

Main Methods:

  • Review of current literature on the surgical treatment of acromegaly.
  • Analysis of factors influencing surgical remission rates, including tumor size and invasiveness.
Keywords:
Acromegalyendoscopypituitaryremission.transsphenoidal surgery

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  • Discussion of postoperative remission criteria and management of residual disease.

    • Main Results:

    • Endoscopic transsphenoidal surgery is the preferred primary treatment for acromegaly, offering rapid normalization of GH and Insulin-like Growth Factor (IGF-1) with low morbidity.
    • Surgical outcomes are significantly influenced by tumor size and invasiveness, with smaller, non-invasive adenomas yielding better remission rates.
    • Postoperative remission rates, based on 2020 consensus criteria, range widely (30-85%), indicating a substantial proportion of patients require further treatment for residual disease.

    Conclusions:

    • Surgery remains the cornerstone of acromegaly treatment, but achieving remission is variable.
    • Careful consideration of residual disease management is crucial for patients who do not achieve remission after initial surgery.
    • Ongoing research and consensus on treatment strategies are vital for optimizing long-term outcomes in acromegaly.