{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:44:59Z","timestamp":1785519899038,"version":"3.56.0"},"reference-count":132,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)\u2013secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of a prospectively maintained database was performed. The authors reviewed cases in which an endoscopic resection of GH-secreting pituitary adenomas was performed. The cohort consisted of 26 patients who had been followed for 3\u201360 months (mean 24.5 months). The thresholds of an age-appropriate, normalized insulin-like growth factor\u2013I concentration, a nadir GH level after oral glucose load of less than 1.0 \u03bcg\/l, and a random GH value of less than 2.5 \u03bcg\/l were required to establish biochemical cure postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, in 57.7% of patients undergoing a purely endoscopic transsphenoidal pituitary adenectomy for acromegaly, an endocrinological cure was achieved. The mean clinical follow-up duration was 24.5 months. In patients with microadenomas (4 cases) the cure rate was 75%, whereas in patients harboring macroadenomas (22 cases) the cure rate was 54.5%. Cavernous sinus invasion (Knosp Grades 3 and 4) was associated with a significantly lower remission rate (p = 0.0068). Hardy Grade 3 and 4 tumors were also less likely to achieve biochemical cure (p = 0.013). The overall complication rate was 11.5% including 2 incidents of transient diabetes insipidus and 1 postoperative CSF leak, which were treated nonoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A purely endoscopic transsphenoidal approach to GH-secreting pituitary adenomas leads to similar outcome for noninvasive macroadenomas compared with traditional microsurgical techniques. Furthermore, this approach may often provide maximal visualization of the tumor, the pituitary gland, and the surrounding neurovascular structures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2010.7.focus10153","type":"journal-article","created":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T09:59:03Z","timestamp":1285927143000},"page":"E5","source":"Crossref","is-referenced-by-count":90,"title":["Outcomes after a purely endoscopic transsphenoidal resection of growth hormone\u2013secreting pituitary adenomas"],"prefix":"10.3171","volume":"29","author":[{"given":"Peter G.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Kenning","sequence":"additional","affiliation":[{"name":"Jefferson Medical College, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Yadla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0290005","series-title":"Eur J Endocrinol","first-page":"23","article-title":"Neurosurgery restores late GH rise after glucose-induced suppression in cured acromegalics","volume":"140","author":"Attanasio","year":"1999"},{"key":"b2-0290005","series-title":"Q J Med","first-page":"293","article-title":"An audit of outcome of treatment in acromegaly","volume":"86","author":"Bates","year":"1993"},{"key":"b3-0290005","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1046\/j.1365-2265.2003.01679.x","article-title":"Long-term outcome and mortality after transsphenoidal adenomectomy for acromegaly","volume":"58","author":"Beauregard","year":"2003"},{"key":"b4-0290005","series-title":"Neuroendocrinol Lett","first-page":"828","article-title":"A follow-up of 130 patients with acromegaly in a single centre","volume":"27","author":"Bolanowski","year":"2006"},{"key":"b5-0290005","series-title":"Rev Endocr Metab Disord","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s11154-007-9061-1","article-title":"Management of acromegaly: is there a role for primary medical therapy?","volume":"9","author":"Bush","year":"2008"},{"issue":"4","key":"b6-0290005","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.1.FOCUS09292","article-title":"Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas","volume":"28","author":"Campbell","year":"2010"},{"key":"b7-0290005","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"293","DOI":"10.3171\/jns.2002.97.2.0293","article-title":"Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas","volume":"97","author":"Cappabianca","year":"2002"},{"key":"b8-0290005","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1227\/01.NEU.0000137330.02549.0D","article-title":"Endoscopic endonasal transsphenoidal surgery","volume":"55","author":"Cappabianca","year":"2004"},{"key":"b9-0290005","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1097\/01.mlg.0000150681.68355.85","article-title":"Endoscopic surgery of the anterior skull base","volume":"115","author":"Casler","year":"2005"},{"key":"b10-0290005","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"99","DOI":"10.3171\/2009.4.JNS09182","article-title":"Endoscopic endonasal transsphenoidal approach for pituitary adenomas invading the cavernous sinus. 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