| Abstract | dc.description.abstract | Background: The treatment of choice for acromegaly is surgery
that, according to the literature, is curative in 91% of pituitary microadenomas and 73% of
macroadenomas. Aim: To report the results of surgical treatment in 53 patients with
acromegaly. Material and methods: Retrospective review of medical records of all patients
with acromegaly, operated between 1984 and 2004. When necessary, patients were contacted
by telephone to complete information or to perform biochemical or imaging studies. A normal
value of insulin like growth factor I (IGF-1) for age and sex, a growth hormone (GH) nadir of
less than 1 ng/ml during a glucose tolerance test or a basal GH of less than 2.5 ng/ml, all
assessed three months after surgery, were considered as criteria for cure. Results: Biochemical
cure was achieved in 67% of patients with pituitary microadenomas and 21% of patients with
macroadenomas. In 47% of patients with neuro-ophtalmological involvement, a partial or total
recovery in the visual field defect was achieved. The most common surgical complications were
transient diabetes insipidus in 19%, persistent diabetes insipidus in 4% and cerebrospinal fluid
fistula in 4%. A lower size of the tumor and lower preoperative growth hormone levels were
associated with a better chance of cure. Conclusions: The cure rates obtained in this group of
patients are clearly lower than those reported abroad. These results stress the importance of
having a national registry of acromegaly and the need to train neurosurgeons in the treatment
of pituitary tumors. | en |
