Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir

Background: The treatment of choice for acromegaly is surgery that, according to the literature, is curative in 91% of pituitary microadenomas and 73% of macroadenomas. Aim: To report the results of surgical treatment in 53 patients with acromegaly. Material and methods: Retrospective review of medi...

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Autores principales: Carrasco M,Carmen, Véliz L,Jesús, Rojas Z,David, Wohllk G,Nelson
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2006
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800007
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spelling oai:scielo:S0034-988720060008000072014-01-23Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenirCarrasco M,CarmenVéliz L,JesúsRojas Z,DavidWohllk G,Nelson Acromegaly Neurosurgery Pituitary neoplasms Background: The treatment of choice for acromegaly is surgery that, according to the literature, is curative in 91% of pituitary microadenomas and 73% of macroadenomas. Aim: To report the results of surgical treatment in 53 patients with acromegaly. Material and methods: Retrospective review of medical records of all patients with acromegaly, operated between 1984 and 2004. When necessary, patients were contacted by telephone to complete information or to perform biochemical or imaging studies. A normal value of insulin like growth factor I (IGF-1) for age and sex, a growth hormone (GH) nadir of less than 1 ng/ml during a glucose tolerance test or a basal GH of less than 2.5 ng/ml, all assessed three months after surgery, were considered as criteria for cure. Results: Biochemical cure was achieved in 67% of patients with pituitary microadenomas and 21% of patients with macroadenomas. In 47% of patients with neuro-ophtalmological involvement, a partial or total recovery in the visual field defect was achieved. The most common surgical complications were transient diabetes insipidus in 19%, persistent diabetes insipidus in 4% and cerebrospinal fluid fistula in 4%. A lower size of the tumor and lower preoperative growth hormone levels were associated with a better chance of cure. Conclusions: The cure rates obtained in this group of patients are clearly lower than those reported abroad. These results stress the importance of having a national registry of acromegaly and the need to train neurosurgeons in the treatment of pituitary tumors (Rev Méd Chile 2006; 134: 989-96).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.134 n.8 20062006-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800007es10.4067/S0034-98872006000800007
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Acromegaly
Neurosurgery
Pituitary neoplasms
spellingShingle Acromegaly
Neurosurgery
Pituitary neoplasms
Carrasco M,Carmen
Véliz L,Jesús
Rojas Z,David
Wohllk G,Nelson
Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir
description Background: The treatment of choice for acromegaly is surgery that, according to the literature, is curative in 91% of pituitary microadenomas and 73% of macroadenomas. Aim: To report the results of surgical treatment in 53 patients with acromegaly. Material and methods: Retrospective review of medical records of all patients with acromegaly, operated between 1984 and 2004. When necessary, patients were contacted by telephone to complete information or to perform biochemical or imaging studies. A normal value of insulin like growth factor I (IGF-1) for age and sex, a growth hormone (GH) nadir of less than 1 ng/ml during a glucose tolerance test or a basal GH of less than 2.5 ng/ml, all assessed three months after surgery, were considered as criteria for cure. Results: Biochemical cure was achieved in 67% of patients with pituitary microadenomas and 21% of patients with macroadenomas. In 47% of patients with neuro-ophtalmological involvement, a partial or total recovery in the visual field defect was achieved. The most common surgical complications were transient diabetes insipidus in 19%, persistent diabetes insipidus in 4% and cerebrospinal fluid fistula in 4%. A lower size of the tumor and lower preoperative growth hormone levels were associated with a better chance of cure. Conclusions: The cure rates obtained in this group of patients are clearly lower than those reported abroad. These results stress the importance of having a national registry of acromegaly and the need to train neurosurgeons in the treatment of pituitary tumors (Rev Méd Chile 2006; 134: 989-96).
author Carrasco M,Carmen
Véliz L,Jesús
Rojas Z,David
Wohllk G,Nelson
author_facet Carrasco M,Carmen
Véliz L,Jesús
Rojas Z,David
Wohllk G,Nelson
author_sort Carrasco M,Carmen
title Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir
title_short Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir
title_full Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir
title_fullStr Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir
title_full_unstemmed Resultados Terapéuticos en pacientes acromegálicos: es tiempo de intervenir
title_sort resultados terapéuticos en pacientes acromegálicos: es tiempo de intervenir
publisher Sociedad Médica de Santiago
publishDate 2006
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800007
work_keys_str_mv AT carrascomcarmen resultadosterapeuticosenpacientesacromegalicosestiempodeintervenir
AT velizljesus resultadosterapeuticosenpacientesacromegalicosestiempodeintervenir
AT rojaszdavid resultadosterapeuticosenpacientesacromegalicosestiempodeintervenir
AT wohllkgnelson resultadosterapeuticosenpacientesacromegalicosestiempodeintervenir
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