We retrospectively analyzed 90 @entity1 who underwent transsphenoidal surgery (performed by three surgeons) in our center as initial therapy for @entity2012 . We used a combination of modern, evidence-based remission criteria including mean day curve GH less than 2.5 micro g/liter (5 mU/liter), a nadir GH less than 1.0 micro g/liter (2 mU/liter) after an oral @entity413 tolerance test, and normal age-related @entity442 levels (where available). Fifty-seven of 90 (63%) @entity1 remained in remission after surgery. Seventy-nine percent of @entity1 with microadenomas but only 56% of @entity1 with macroadenomas achieved remission (P < 0.001). Eighty-six percent of @entity1 with preoperative GH levels below 10 micro g/liter (day profile or after oral @entity413 tolerance test) went into remission, compared with 51% of @entity1 with GH levels above 25 micro g/liter at diagnosis (P < 0.002). The remission rate was also related to the period of surgery that was significantly higher in 1998-2001 (76%; P < 0.05) compared with 1990-1997 (54%) and 1980-1989 (63%). There were no recurrences or perioperative @entity204 . @entity693 occurred in 3% of @entity1 , @entity5254 in 7%, and permanent @entity2010 in 15%. The proportion of @entity1 who developed new anterior @entity7961 and @entity7961 was significantly less in the period 1998-2001 (P < 0.001) when compared with the periods from 1990-1997 and 1980-1989. Transsphenoidal surgery is a safe and effective treatment for @entity2012 , and our results compare favorably with those from published series. The presence of an intrasellar lesion and low preoperative GH levels is a good predictor of remission in the long term, but historically in our center this can only be achieved in a significant proportion of @entity1 at the expense of some degree of @entity4614 . However, surgical outcome in our center, including a reduced frequency of @entity4614 , has improved significantly over time, coincident with the arrival of a dedicated pituitary neurosurgeon and the use of selective adenomectomy as the preferred surgical approach wherever possible.

Transsphenoidal surgery for XXXX in wales: results based on stringent criteria of remission.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity442 :: ('3479', 'Gene') :: ['IGF-I'] @entity693 :: ('MESH:D008581', 'Disease') :: ['Meningitis'] @entity2012 :: ('MESH:D000172', 'Disease') :: ['acromegaly'] @entity5254 :: ('MESH:D002559', 'Disease') :: ['cerebrospinal fluid rhinorrhea'] @entity4614 :: ('MESH:D007018', 'Disease') :: ['hypopituitarism'] @entity7961 :: ('MESH:C580003', 'Disease') :: ['panhypopituitarism', 'pituitary hormone deficiencies'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity2010 :: ('MESH:D003919', 'Disease') :: ['diabetes insipidus']
@entity2012 :: (MESH:D000172,Disease) :: ['acromegaly']
