Functional treatment of acromegaly by transsphenoidal microsurgery

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Abstract
The results from 41 acromegalic patients who underwent transsphenoidal surgery were analyzed. In 31 patients, postoperative growth hormone (GH) levels fell and remained below 10 ng/ml. This represents an endocrinological "cure" of 78%. In the remaining 10 cases, postoperative GH [growth hormone] values were not stabilized below 10 ng/ml, although 7 showed some clinical improvement. The results were particularly good in those cases of localized adenomas, which allowed a selective removal while maintaining pituitary function within normal limits in 65.5% of cases. The postoperative GH level in this group fell and remained below 10 ng/ml in more than 90% of cases. Four patients required reoperation to normalize the GH levels which had not been sufficiently modified after the 1st operation; only 1 of them remained with plasma GH levels above normal limits. There were no deaths in this series. Rhinorrhea occurred as a postsurgical complication in 4 cases. In 3 this disappeared with bed rest and lumbar drainage; in the other, surgical repair was necessary. The occurrence of surgical complications decreased as experience increased, and the need for reoperation was unusual after the 1st year of the study.

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