{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:10:18Z","timestamp":1780629018152,"version":"3.54.1"},"reference-count":50,"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>Acromegaly is a chronic disease related to the excess of growth hormone (GH) and insulin-like growth factor\u2013I secretion, usually by pituitary adenomas. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The introduction of endoscopy as an additional tool for surgical treatment of pituitary adenomas and, therefore, acromegaly represents an important advance of pituitary surgery in the recent years. The aim of this retrospective study is to evaluate the results of pure transsphenoidal endoscopic surgery in a series of patients with acromegaly who were operated on by a pituitary specialist surgeon. The authors discuss the advantages, outcome, complications, and factors related to the success of the endoscopic approach in cases of GHsecreting adenomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors retrospectively analyzed data from cases involving patients with GH-secreting adenomas who underwent pure transsphenoidal endoscopic surgery at the Department of Neurosurgery of the General Hospital in Fortaleza, Brazil, between 2000 and 2009. Tumors were classified according to size as micro- or macroadenomas, and tumor extension was analyzed based on suprasellar\/parasellar extension and sella floor destruction. All patients were followed up for at least 1 year. The criteria of disease control were GH levels &lt; 1 ng\/L after oral glucose tolerance test and normal insulin-like growth factor\u2013I levels for age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study period, 67 patients underwent pure endoscopic transsphenoidal surgery for treatment of acromegaly. Disease control was obtained in 50 cases (74.6%). The rate of treatment success was higher in patients with microadenomas (disease control achieved in 12 [85.7%] of 14 cases) than in those with larger lesions. Suprasellar\/parasellar extension and high levels of sella floor erosion were associated with lower rates of disease control (p = 0.01 and p = 0.02, respectively). Complications related to the endoscopic surgery included epistaxis (6.0%), transitory diabetes insipidus (4.5%), and 1 case of seizure (1.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic transsphenoidal surgery represents an effective option for treatment of patients with acromegaly. High disease control rates and a small number of complications are some of the most important points related to the technique. Factors related to the success of the endoscopic surgery are lesion size, suprasellar\/parasellar extension, and the degree of sella floor erosion. Although presenting important advantages, there is no conclusive evidence that endoscopy is superior to microsurgery in treatment of GH-secreting adenomas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2010.7.focus10167","type":"journal-article","created":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T09:59:03Z","timestamp":1285927143000},"page":"E7","source":"Crossref","is-referenced-by-count":79,"title":["Pure endoscopic transsphenoidal surgery for treatment of acromegaly: results of 67 cases treated in a pituitary center"],"prefix":"10.3171","volume":"29","author":[{"given":"Jackson A.","family":"Gondim","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Paulo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Campinas State University, Campinas, Sao Paulo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Alverne F.","family":"de Albuquerque","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Gomes","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Schops","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Federal University of Ceara, Fortaleza, Ceara;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Endocrinology, General Hospital of Fortaleza;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0290007","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.surneu.2005.11.063","article-title":"A prospective analysis of 151 cases of patients with acromegaly operated by one neurosurgeon: a follow-up of more than 23 years","volume":"66","author":"Abbassioun","year":"2006"},{"key":"b2-0290007","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1046\/j.1365-2265.1999.00760.x","article-title":"Outcome of transsphenoidal surgery for acromegaly and its relationship to surgical experience","volume":"50","author":"Ahmed","year":"1999"},{"key":"b3-0290007","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1055\/s-2008-1052019","article-title":"Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS)","volume":"41","author":"Cappabianca","year":"1998"},{"key":"b4-0290007","series-title":"Best Pract Res Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.beem.2009.05.010","article-title":"Pituitary tumours: acromegaly","volume":"23","author":"Chanson","year":"2009"},{"key":"b5-0290007","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"570","DOI":"10.3171\/jns.2005.103.3.0570","article-title":"Cushing's first case of transsphenoidal surgery: the launch of the pituitary surgery era","volume":"103","author":"Cohen-Gadol","year":"2005"},{"key":"b6-0290007","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1007\/s11102-008-0138-y","article-title":"Acromegaly and gigantism in the medical literature. 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