ECE2007 Poster Presentations (1) (659 abstracts)
Endocrinology Scientific Centre, Moscow, Russia.
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.