Outcome of surgery for acromegaly performed by different surgeons: Importance of surgical experience

被引：46

作者：

Erturk E. ^{[1
]}

Tuncel E. ^{[1
]}

Kiyici S. ^{[1
]}

Ersoy C. ^{[1
]}

Duran C. ^{[1
]}

Imamoglu S. ^{[1
]}

机构：

[1] Department of Endocrinology, Uludag University, School of Medicine

来源：

Pituitary | 2005年 / 8卷 / 2期

关键词：

Acromegaly; Hypopituitarism; Octreotide; Transsphenoidal surgery;

D O I：

10.1007/s11102-005-3280-9

中图分类号：

学科分类号：

摘要：

Aim: The aim of this study was to evaluate transsphenoidal surgery results in acromegalic patients which were performed not by a single surgeon but by different surgeons. Methods: The study included 30 (M/F: 13/17) patients whose follow-up data were available. Basal or nadir postglucose growth hormone levels of less than 2 ng/ml were accepted as cure criteria. Six of them underwent a further operation due to previous surgical failure. Results: Cure was achieved in 33% of patients while hypopituitarism was observed in 10% (3/30) of patients after the first operation. The cure rates were 63% and 15% in patients with microadenomas (n = 11) and macroadenomas (n = 19) respectively (p = 0.042). Only one of the patients (16%) who underwent a second operation achieved remission, while hypopituitarism was observed in five of them (83%). There was no significant difference in the cure rates between the first and second operation, but the risk of hypopituitarism was significantly higher in patients who underwent further surgery (p = 0.008). Conclusion: The cure rate following surgery is significantly lower in acromegalic patients with macroadenomas than in patients with microadenomas. Cure probability decreases with a further operation, while complication risk increases significantly. Octreotide therapy, which could be used as an alternative therapy to the surgery, revealed high success rates in both microadenomas and macroadenomas. The low cure rates found in this study compared with published series could be attributed to the fact that operations were performed by inexperienced surgeons. © 2005 Springer Science + Business Media, Inc.

引用

页码：93 / 97

页数：4

共 25 条

[1]

Melmed S., Jackson I., Kleinberg D., Klibanski A., Current treatment guidelines for acromegaly, J Clin Endocrinol Metab, 83, pp. 2646-2652, (1998)

[2]

Holdaway I.M., Rajasoorya C.R., Gamble G.D., Stewart A.W., Long-term treatment outcome in acromegaly, Growth Horm IGF Res, 13, pp. 185-192, (2003)

[3]

Sheaves R., Jenkins P., Blackburn P., Huneidi A.H., Afshar F., Medbak S., Grossman A.B., Besser G.M., Wass J.A., Outcome of transsphenoidal surgery for acromegaly using strict criteria for surgical cure, Clin Endocrinol (Oxf), 45, pp. 407-413, (1996)

[4]

Abosch A., Tyrrell J.B., Lamborn K.R., Hannegan L.T., Applebury C.B., Wilson C.B., Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: Initial outcome and long-term results, J Clin Endocrinol Metab, 83, pp. 3409-3410, (1998)

[5]

Colao A., Ferone D., Marzullo P., Cappabianca P., Cirillo S., Boerlin V., Lancranjan I., Lombardi G., Long-term effects of depot long-acting somatostatin analog octreotide on hormone levels and tumor mass in acromegaly, J Clin Endocrinol Metab, 86, pp. 2779-2786, (2001)

[6]

Cozzi R., Attanasio R., Montini M., Pagani G., Lasio G., Lodrini S., Barausse M., Albizzi M., Dallabonzana D., Pedroncelli A.M., Four-year treatment with octreotide-long-acting repeatable in 110 acromegalic patients: Predictive value of short-term results?, J Clin Endocrinol Metab, 88, pp. 3090-3098, (2003)

[7]

Shimon I., Cohen Z.R., Ram Z., Hadani M., Transsphenoidal surgery for acromegaly: Endocrinological follow-up of 98 patients, Neurosurgery, 48, pp. 1239-1243, (2001)

[8]

Gittoes N.J., Sheppard M.C., Johnson A.P., Stewart P.M., Outcome of surgery for acromegaly-the experience of a dedicated pituitary surgeon, QJM, 92, pp. 741-745, (1999)

[9]

Fahlbusch R., Honegger J., Buchfelder M., Evidence supporting surgery as treatment of choice for acromegaly, J Endocrinol, 155, SUPPL. 1, (1997)

[10]

Lissett C.A., Peacey S.R., Laing I., Tetlow L., Davis J.R., Shalet S.M., The outcome of surgery for acromegaly: The need for a specialist pituitary surgeon for all types of growth hormone (GH) secreting adenoma, Clin Endocrinol (Oxf), 49, pp. 653-657, (1998)

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