# Surgical Outcomes and Complications of Patients With Acromegaly in Qatar

## TL;DR

This study examines the surgical outcomes and complications of acromegaly patients in Qatar, finding that endoscopic surgery leads to good remission and low complication rates.

## Contribution

The study provides insights into surgical outcomes for acromegaly in a Qatari population, highlighting favorable results with endoscopic transsphenoidal resection.

## Key findings

- ETT surgery achieved high biochemical remission rates and complete tumor resection in most patients.
- Densely granulated somatotroph adenomas were associated with better surgical outcomes.
- Postoperative complications were low, with preserved pituitary function in 73.9% of patients.

## Abstract

Background: Acromegaly is a rare endocrine disorder. It results from excess growth hormone (GH) secretion, predominantly due to pituitary adenomas. Endoscopic trans-nasal transsphenoidal (ETT) resection remains the primary treatment modality. Adjunctive medical and radiotherapeutic interventions are required for incomplete remission. This study evaluates the surgical outcomes and complications in patients with acromegaly managed at Hamad General Hospital (HGH), Qatar.

Methods: This retrospective study includes patients diagnosed with acromegaly and managed at HGH between January 2010 and May 2025. Only patients with confirmed acromegaly and available preoperative and postoperative hormonal assessments and imaging were included. Hormonal remission rates, extent of tumor resection, and postoperative complications were the key outcomes.

Results: A total of 45 patients were included; 23 underwent surgery at HGH. The median patient age was 43 years, with a total of 39 males. ETT resection was the sole surgical modality. Postoperatively sustained biochemical remission was observed in most cases at 12-month follow-up with lowered insulin-like growth factor-1 levels (IGF-1). Lower recurrence rates (17.3% vs. 8.88%) and a higher proportion of complete tumor resection were evident in the group of patients operated at HGH. Postoperative pituitary function was preserved in 73.9% of patients with a low incidence of complications such as cerebrospinal fluid (CSF) leaks, diabetes insipidus, and infections. Histopathology revealed a predominance of densely granulated somatotroph adenomas in the HGH group, associated with improved surgical outcomes.

Conclusion: ETT surgery remains an effective primary treatment for acromegaly. Favorable biochemical remission rates and tumor resection outcomes are observed in patients managed at HGH. The predominance of densely granulated somatotroph adenomas in this cohort may have contributed to the observed favorable surgical outcomes. Further large multicenter studies are warranted to validate these conclusions.