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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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/29073 |
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I10-R327-article-29073 |
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Universidad Nacional de Córdoba |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
acromegaly neurosurgery postoperative complications remission induction acromegalia neurocirugía complicaciones postoperatorias inducción de remisión acromegalia neurocirurgia complicações pós-operatórias indução de remissão |
| spellingShingle |
acromegaly neurosurgery postoperative complications remission induction acromegalia neurocirugía complicaciones postoperatorias inducción de remisión acromegalia neurocirurgia complicações pós-operatórias indução de remissão 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 Surgical treatment in acromegaly: experience in Córdoba |
| topic_facet |
acromegaly neurosurgery postoperative complications remission induction acromegalia neurocirugía complicaciones postoperatorias inducción de remisión acromegalia neurocirurgia complicações pós-operatórias indução de remissão |
| author |
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 |
| author_facet |
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 |
| author_sort |
Rendón, Matilde Inés |
| title |
Surgical treatment in acromegaly: experience in Córdoba |
| title_short |
Surgical treatment in acromegaly: experience in Córdoba |
| title_full |
Surgical treatment in acromegaly: experience in Córdoba |
| title_fullStr |
Surgical treatment in acromegaly: experience in Córdoba |
| title_full_unstemmed |
Surgical treatment in acromegaly: experience in Córdoba |
| title_sort |
surgical treatment in acromegaly: experience in córdoba |
| description |
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. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/29073 |
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I10-R327-article-290732024-08-27T18:28:34Z Surgical treatment in acromegaly: experience in Córdoba Tratamiento quirúrgico en acromegalia: experiencia en Córdoba Tratamento cirúrgico na acromegalia: experiência em Córdoba 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 acromegaly neurosurgery postoperative complications remission induction acromegalia neurocirugía complicaciones postoperatorias inducción de remisión acromegalia neurocirurgia complicações pós-operatórias indução de remissão 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. Introducción: La acromegalia tiene una prevalencia de 35-70/millón. La cirugía transesfenoidal es el tratamiento de elección, siendo la tasa de remisión del 80% en microadenomas y 50% en macroadenomas. Debido a la falta de registros, nos propusimos evaluar los resultados quirúrgicos en Córdoba y determinar factores predictivos de remisión. Métodos: Estudio retrospectivo-descriptivo de pacientes con cirugía como primera línea terapéutica. Criterios de remisión: normalización de IGF1 para edad/sexo, con GH ≤1,0 g/L.Test X2 y test exacto de Fisher y p<0,05. Resultados: Se incluyeron 38 pacientes: 61% mujeres y 39% hombres; edad promedio 45 años. Motivos de consulta más frecuentes: cefalea y crecimiento acral (26%), alteraciones visuales (20%). El 84% de los tumores fueron macroadenomas. De 37 pacientes, 54% se sometieron a cirugía microscópica, 38% endoscópica y 8% transcraneal. El 29% evidenció complicaciones postquirúrgicas, siendo la diabetes insípida la más frecuente (10%). El porcentaje de las mismas fue: cirugía transcraneal el 33%, endoscópica 29% y microscópica 25% (p= 0,557). La remisión bioquímica a los 6 meses fue de 34% y a los 12 meses 55% (p=0,0001). Sin diferencias significativas entre la vía endoscópica y microscópica (p=0,071). De 36 pacientes el 31% evidenció resección tumoral completa. La mejoría clínica subjetiva fue del 88%. No hubo factores predictivos de remisión bioquímica estadísticamente significativos. Conclusión: La remisión bioquímica con la cirugía fue similar a la bibliografía. No encontramos factores predictivos de remisión pero un número mayor de casos podría modificar estos resultados. Introdução: A acromegalia tem uma prevalência de 35-70 / milhão. A cirurgia transesfenoidal é o tratamento de escolha, comtaxa de remissão de 80% nos microadenomas e 50% nos macroadenomas. Decidimos avaliar os resultados cirúrgico sem Córdoba e determinar os fatores preditivos de remissão devido à falta de registros. Métodos: Estudo retrospectivo-descritivo de pacientes operados como primeira linha terapêutica. Critérios de remissão: normalização do IGF1 para idade/sexo, com GH ≤1,0 g/L. Teste X2 e teste exato de Fisher ep<0,05. Resultados: 38 pacientes foram incluídos: 61% mulheres e 39% homens; Idade média: 45 anos. Razões mais frequentes para consulta: dor de cabeça e crescimento acral (26%), disturbios visuais (20%). 84% dos tumores eran macroadenomas. Dos 37 pacientes, 54% foram submetidos a cirurgia microscópica, 38% endoscópica e 8% transcraniana. 29% apresentaram complicações pós-operatórias, sendo o diabetes insípido o mais frequente (10%). O percentual deles foi: 33% de cirurgia transcraniana, 29% de endoscopia e 25% de microscopia (p= 0,557). A remissão bioquímica aos 6 meses foi de 34% e aos 12 meses de 55% (p = 0,0001). Não houve diferenças significativas entre a via endoscópica e microscópica (p = 0,071). Dos 36 pacientes, 31% apresentaram ressecção completa do tumor. A melhora clínica subjetiva foi de 88%. Nãohouvefatorespreditivos de remissão bioquímica estatisticamente significativos. Conclusão: A remissão bioquímica comcirurgia foisem elhante à bibliografia. Não encontramos fatores preditivos de remissão, mas um número maior de casos poderia modificar esses resultados. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-12-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/29073 10.31053/1853.0605.v77.n4.29073 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 4 (2020); 301-306 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 4 (2020); 301-306 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 4 (2020); 301-306 1853-0605 0014-6722 10.31053/1853.0605.v77.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/29073/32421 https://revistas.unc.edu.ar/index.php/med/article/view/29073/32478 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |