Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly

Abstract Objective Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in two referral centers in Korea. Methods We enrolled 134 patients with acromegaly (microadenomas, n=15; macroadenomas, n=119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n=74) and Samsung Medical center (n=60) between Jan 2009 and Mar 2016. Remission was defined as having a normal IGF-1 and a suppressed GH less than 1 ng/mL during an oral glucose tolerance test. Results Remission was achieved in 73.1% of patients, including 13/15 microadenoma patients (86.7%) and 86/119 macroadenoma patients (72.3%). A multivariate analysis to determine a predictor of biochemical remission demonstrated that absence of cavernous sinus invasion and immediate postoperative GH levels of Conclusions Endoscopic transsphenoidal surgery for acromegaly presented high remission rates and a low incidence of endocrine deficits and complications. Regardless of surgical techniques, invasive pituitary tumors were associated with poor outcome.