Endoscopic Transsphenoidal Surgery: Retrospective Analysis of Patients with a Known History of Acromegaly

Introduction: Acromegaly is a disorder multisystem-associated morbidities, and increased mortality. Depending on its progression stage, may not manifest with clear diagnostic features. Currently transsphenoidal surgery is the first line treatment of acromegaly. We present here the institutional experience in the approach of these patients from 2005 to 2012 at Hospital Universitario San Ignacio in Bogotá, Colombia.

Methods: Acromegaly patients who were treated in our department were evaluated retrospectively. Presenting features and assessment of comorbidities, further evaluation after diagnosing acromegaly and performing fully endoscopic transsphenoidal approaches and postoperative management.

Results: A total of 21 acromegaly patients (8 men and 13 women) were included. Typical acromegaly signs and symptoms including somatic enlargement and jaw overgrowth were the most frequent feature at the time of diagnosis. The diabetes mellitus and hypertension were the main comorbidities. 71% of tumors were macroadenomas. Endoscopic transsphenoidal surgery was performed in all the patients, 3 months after surgery 62% of these patients had disease free criteria. However some patients required post-operative adjuvant therapy as medical therapy, radiation therapy and in one case reoperation.

Conclusions: Endoscopic transsphenoidal surgery represents an effective option for treatment of patients with acromegaly. It is possible that some of these cases will continue to require requiring therapy even after surgical removal of the tumor. Patients with acromegaly need frequent postoperative monitoring for maintaining favorable outcomes.