Results of treatment of patients with pituitary somatotroph adenomas
Andrey Grigoriev, Natalye Molitvoslovova, Galina Kolesnikova & Anatolij Kuzmin
In ESC for the period since October 2004 till October 2006 were operated 69 patients with acromegaly. Men were 22 (32%), women 47 (68%). Age of patients changed from 24 till 68 (middle 47).
All patients were separated into 2 groups: surgery (group 1) and combination treatment (group 2), which consist of surgery and somatostatin analogues therapy before and after surgery.
In most cases were macroadenomas, only 5 patients (7%) had microadenomas. Suprasellar invasion had 21 patients (30%), infrasellar 28 (41%) and 32% patients had invasion to one or both cavernous sinuses.
50 patients operated by transnasal approach and 19 with endoscopic techniques. In 47 cases (69%) tumor was total removal, in 17 subtotal (not less 90% tumor mass was removal), and in 5 cases (7%) partial removal.
Results: Significant clinical improvement is seen in most patients 66 (97%). Reduce diabetes mellitus we observed at 43% patients (6 from 14), visual improvement had 78% patients (14 from 18).
Nobody had CSF leak after operation. Diabetes insipidus had 6 patients (9%). Pulmonary embolus had 3 patients (1 patient died).
After 612 months were examination 14 patients from group 1 and group 2. GR was normalized in 79% of patients of each group. IGF-1 was normalized in 75% of each group. And postglucose GH level was normalized in 46% into group 1 and 58% into group 2.
Conclusion: Transsphenoidal surgery for acromegaly is safe and effective treatment with minimal mortality and morbidity.
Obvious distinctions in postoperative dynamics IGF-1 and postglucose GH in both groups it is not revealed. There is a tendency in greater efficiency of the combined treatment.