Surgical treatment in acromegaly: experience in Córdoba

Introduction: Acromegaly prevalence is 35-70 / million. Transsphenoidal surgery is the first-line treatment, with a remission rate of 80% for microadenomas and 50% for macroadenomas. Our aim was to evaluate the surgical results in Córdoba and determine predictive remission factors due to the lack of...

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Detalles Bibliográficos
Autores principales: Rendón, Matilde Inés, Cecenarro, Laura Anahi, Andrada, Marta C., Barovero, Mariela Susana, Bertolino, María Lorena, Cagliolo, Mariela, Carpentieri , Ágata R., Damilano, Roxana Analía, De Battista, Juan Carlos, Estario, Paula, Fernández, Silvia, M´arquez, Maria Eugenia, Monteserin, Natalia, Quintero, María Lorena, Sala, Claudia Susana, Sosa, Gabriela Alejandra, Surraco, María Elena, De Paul, Ana Lucía, Szafryk de Mereshian, Paula, Fux Otta, Carolina
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020
Materias:
acromegaly
neurosurgery
postoperative complications
remission induction
acromegalia
neurocirugía
complicaciones postoperatorias
inducción de remisión
neurocirurgia
complicações pós-operatórias
indução de remissão
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/29073
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
Descripción
Sumario:Introduction: Acromegaly prevalence is 35-70 / million. Transsphenoidal surgery is the first-line treatment, with a remission rate of 80% for microadenomas and 50% for macroadenomas. Our aim was to evaluate the surgical results in Córdoba and determine predictive remission factors due to the lack of records. Methods: Retrospective-descriptive study of patients with surgery as the first therapeutic line. Remission criteria: IGF1 normalization for age/sex, with GH ≤1.0 g/L. Test X2 and Fisher's exact test with p<0.05. Results: 38 patients were included: 61% women and 39% men; Average age 45 years. Most frequent chief complaint: headache and acral growth (26%), visual disturbances (20%). Macroadenomas were the 84% of the tumors. Of 37 patients, 54% underwent microscopic surgery, 38% endoscopic and 8% transcranial. The 29% of patients showed post-operative complications and diabetes insipidus was the most frequent (10%). The percentage of them was: 33% transcranial surgery, 29% endoscopic and 25% microscopic (p = 0.557). The biochemical remission at 6 months was 34% and at 12 months 55% (p= 0.0001). No significant differences between the endoscopic and microscopic approach (p = 0.071). Of 36 patients, 31% showed complete tumor resection. The subjective clinical improvement was 88%. There weren´t predictive remission factors with significant differences. Conclusion: The surgical biochemical remission was similar to the bibliography. We didn´t find predictive remission factors but a larger number of patients could modify these results.

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