Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas
Growth hormone (GH)-secreting pituitary adenomas (PA) make up 15 to 20% of total amount of hormonally active adenomas. In addition to acromegaly and gigantism, these tumors cause deep metabolic disturbances. Its systemic impact leads to increased mortality ratio of 1.32 compared with general populat...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-03-01
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| Series: | Indian Journal of Neurosurgery |
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| author | Oleksandr Voznyak Andrii Lytvynenko Oleg Maydannyk Roman Ilyuk Yaroslav Zinkevych Nazarii Hryniv |
| author_facet | Oleksandr Voznyak Andrii Lytvynenko Oleg Maydannyk Roman Ilyuk Yaroslav Zinkevych Nazarii Hryniv |
| author_sort | Oleksandr Voznyak |
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| description | Growth hormone (GH)-secreting pituitary adenomas (PA) make up 15 to 20% of total amount of hormonally active adenomas. In addition to acromegaly and gigantism, these tumors cause deep metabolic disturbances. Its systemic impact leads to increased mortality ratio of 1.32 compared with general population. Surgical removal remains the priority treatment option in controlling acromegaly and provides endocrinologic remission in up to 72% patients. A total of 92 patients were included in the study. All surgeries were performed via microscopic transsphenoidal approach (TSA) by the senior author in our institution between December 2009 and October 2019. Only patients who were followed-up with 75 g oral glucose tolerance tests (OGTTs), GH, and insulin-like growth factor I (IFG-I) measurements preoperatively, 1 week, and every 6 months postoperatively were analyzed. Based on standard preoperative 1.5-T MR imaging with contrast enhancement, the adenomas were identified and distributed according to the size and KNOSP classification. The efficacy depends on KNOSP grade, which is directly correlated with invasiveness to cavernous sinus (CS). Grades 3 and 4 are unfavorable factors influencing prognosis. Excluding grade 0 adenomas, as the surgery was not difficult with the excellent outcomes, we reached 75% (36 out of 48) remission in grade 1 to 2 groups. In contrast, only 17% (2 out of 12) had successful outcomes after surgery alone. In conclusion, the study demonstrates the efficiency of TS surgery in patients with confirmed GH-secreting PA. |
| format | Article |
| id | doaj-art-55c9bf7add6c4468ab8e4f1649ad313e |
| institution | OA Journals |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-55c9bf7add6c4468ab8e4f1649ad313e2025-08-20T01:57:15ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672021-03-01100106106410.1055/s-0041-1726134Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary AdenomasOleksandr Voznyak0Andrii Lytvynenko1Oleg Maydannyk2Roman Ilyuk3Yaroslav Zinkevych4Nazarii Hryniv5Centre of Neurosurgery, Clinical Hospital “Feofaniya,” Kyiv, UkraineCentre of Neurosurgery, Clinical Hospital “Feofaniya,” Kyiv, UkraineCentre of Neurosurgery, Clinical Hospital “Feofaniya,” Kyiv, UkraineCentre of Neurosurgery, Clinical Hospital “Feofaniya,” Kyiv, UkraineCentre of Neurosurgery, Clinical Hospital “Feofaniya,” Kyiv, UkraineDepartment of Neurosurgery, Shupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineGrowth hormone (GH)-secreting pituitary adenomas (PA) make up 15 to 20% of total amount of hormonally active adenomas. In addition to acromegaly and gigantism, these tumors cause deep metabolic disturbances. Its systemic impact leads to increased mortality ratio of 1.32 compared with general population. Surgical removal remains the priority treatment option in controlling acromegaly and provides endocrinologic remission in up to 72% patients. A total of 92 patients were included in the study. All surgeries were performed via microscopic transsphenoidal approach (TSA) by the senior author in our institution between December 2009 and October 2019. Only patients who were followed-up with 75 g oral glucose tolerance tests (OGTTs), GH, and insulin-like growth factor I (IFG-I) measurements preoperatively, 1 week, and every 6 months postoperatively were analyzed. Based on standard preoperative 1.5-T MR imaging with contrast enhancement, the adenomas were identified and distributed according to the size and KNOSP classification. The efficacy depends on KNOSP grade, which is directly correlated with invasiveness to cavernous sinus (CS). Grades 3 and 4 are unfavorable factors influencing prognosis. Excluding grade 0 adenomas, as the surgery was not difficult with the excellent outcomes, we reached 75% (36 out of 48) remission in grade 1 to 2 groups. In contrast, only 17% (2 out of 12) had successful outcomes after surgery alone. In conclusion, the study demonstrates the efficiency of TS surgery in patients with confirmed GH-secreting PA.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1726134pituitary adenomaacromegalytranssphenoidal approach |
| spellingShingle | Oleksandr Voznyak Andrii Lytvynenko Oleg Maydannyk Roman Ilyuk Yaroslav Zinkevych Nazarii Hryniv Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas Indian Journal of Neurosurgery pituitary adenoma acromegaly transsphenoidal approach |
| title | Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas |
| title_full | Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas |
| title_fullStr | Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas |
| title_full_unstemmed | Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas |
| title_short | Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas |
| title_sort | outcomes of transsphenoidal surgery in growth hormone secreting pituitary adenomas |
| topic | pituitary adenoma acromegaly transsphenoidal approach |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1726134 |
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