Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly
IntroductionSomatotropinomas are the main cause of acromegaly. Surgery is the primary and most efficient method of treatment. The study aimed to compare the radicality of small-sized and medium (<30 mm) somatotropinoma removal and the incidence of postoperative complications in patients with...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1128345/full |
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| author | Natalya Vassilyeva Natmir Mena Kiril Kirov Ekaterina Diatlova |
| author_facet | Natalya Vassilyeva Natmir Mena Kiril Kirov Ekaterina Diatlova |
| author_sort | Natalya Vassilyeva |
| collection | DOAJ |
| description | IntroductionSomatotropinomas are the main cause of acromegaly. Surgery is the primary and most efficient method of treatment. The study aimed to compare the radicality of small-sized and medium (<30 mm) somatotropinoma removal and the incidence of postoperative complications in patients with acromegaly when using microscopic and endoscopic techniques.MethodsIn this randomized controlled trial, a total of 83 patients with acromegaly underwent transspheroidal endoscopy or microscopic surgery. Somatotropinoma was the cause of acromegaly in all cases. Patients were randomly divided into two comparison groups depending on the applied surgical technique. Group 1 (n = 40) consisted of patients who underwent adenomectomy with transnasal transsphenoidal access by a microscope. Group 2 (n = 43) included patients who underwent the same surgical procedure with an endoscope. The following indicators were assessed: radicality of tumor removal, treatment effectiveness, postoperative complications, and remission rate.ResultsThe study has shown that removal of somatotropinoma in patients with acromegaly using endoscopic technique increases the radicality of tumor removal in comparison with microscopic technique. Total removal of somatotropinoma was successful in 88.4% of cases when using the endoscopic technique. Secondly, the segmentation of patients according to their tumor characteristics poses challenges, primarily owing to the rarity of acromegaly as a disease. The difference between groups was not statistically significant (p=1.02). There were no statistically significant differences in basal GH level and IGF-1 level between groups (p=0.546 and p=0.784, respectively).DiscussionEndonasal transsphenoidal endoscopic adenomectomy is proven efficacy, a less traumatic degree, and higher somatotropinoma removal radicality. Both surgical methods lead to disease remission. |
| first_indexed | 2024-03-12T01:34:43Z |
| format | Article |
| id | doaj.art-f6b089c651d24c0e955f9f2fc1b865f9 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-12T01:34:43Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-f6b089c651d24c0e955f9f2fc1b865f92023-09-11T11:14:07ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-09-011410.3389/fendo.2023.11283451128345Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegalyNatalya Vassilyeva0Natmir Mena1Kiril Kirov2Ekaterina Diatlova3Department Emergency Medicine, Anesthesiology and Resuscitation, Karaganda Medical University, Karaganda, KazakhstanDepartment of General Surgery, Medical University Pleven, Pleven, BulgariaResearch Institute, Medical University Pleven, Pleven, BulgariaDepartment of Nursing Management and Social Work, Sechenov First Moscow State Medical University, Moscow, RussiaIntroductionSomatotropinomas are the main cause of acromegaly. Surgery is the primary and most efficient method of treatment. The study aimed to compare the radicality of small-sized and medium (<30 mm) somatotropinoma removal and the incidence of postoperative complications in patients with acromegaly when using microscopic and endoscopic techniques.MethodsIn this randomized controlled trial, a total of 83 patients with acromegaly underwent transspheroidal endoscopy or microscopic surgery. Somatotropinoma was the cause of acromegaly in all cases. Patients were randomly divided into two comparison groups depending on the applied surgical technique. Group 1 (n = 40) consisted of patients who underwent adenomectomy with transnasal transsphenoidal access by a microscope. Group 2 (n = 43) included patients who underwent the same surgical procedure with an endoscope. The following indicators were assessed: radicality of tumor removal, treatment effectiveness, postoperative complications, and remission rate.ResultsThe study has shown that removal of somatotropinoma in patients with acromegaly using endoscopic technique increases the radicality of tumor removal in comparison with microscopic technique. Total removal of somatotropinoma was successful in 88.4% of cases when using the endoscopic technique. Secondly, the segmentation of patients according to their tumor characteristics poses challenges, primarily owing to the rarity of acromegaly as a disease. The difference between groups was not statistically significant (p=1.02). There were no statistically significant differences in basal GH level and IGF-1 level between groups (p=0.546 and p=0.784, respectively).DiscussionEndonasal transsphenoidal endoscopic adenomectomy is proven efficacy, a less traumatic degree, and higher somatotropinoma removal radicality. Both surgical methods lead to disease remission.https://www.frontiersin.org/articles/10.3389/fendo.2023.1128345/fullsomatotropinomaacromegalyadenomectomymicroscopic techniquesendoscopic techniques |
| spellingShingle | Natalya Vassilyeva Natmir Mena Kiril Kirov Ekaterina Diatlova Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly Frontiers in Endocrinology somatotropinoma acromegaly adenomectomy microscopic techniques endoscopic techniques |
| title | Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly |
| title_full | Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly |
| title_fullStr | Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly |
| title_full_unstemmed | Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly |
| title_short | Comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly |
| title_sort | comparative effectiveness of endoscopic and microscopic adenoma removal in acromegaly |
| topic | somatotropinoma acromegaly adenomectomy microscopic techniques endoscopic techniques |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1128345/full |
| work_keys_str_mv | AT natalyavassilyeva comparativeeffectivenessofendoscopicandmicroscopicadenomaremovalinacromegaly AT natmirmena comparativeeffectivenessofendoscopicandmicroscopicadenomaremovalinacromegaly AT kirilkirov comparativeeffectivenessofendoscopicandmicroscopicadenomaremovalinacromegaly AT ekaterinadiatlova comparativeeffectivenessofendoscopicandmicroscopicadenomaremovalinacromegaly |