Transsphenoidal hypophysectomy in Beagle dogs: Evaluation of a microsurgical technique
Transsphenoidal hypophysectomy in Beagle dogs: Evaluation of a microsurgical technique
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DOI：
10.1111/j.1532-950x.1997.tb01502.x
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发表时间：
1997-07-01
影响因子：
1.8
通讯作者：
VantVerlaat, JW
中科院分区：
文献类型：
--
作者：
Meij, BP;Voorhout, G;VantVerlaat, JW
目的-评估犬经蝶垂体切除术的显微外科技术。研究设计-使用体格检查、垂体功能测试、计算机断层扫描 (CT) 和尸检时的组织学检查进行前瞻性研究。动物或样本群体-8 只实验室比格犬。方法-在垂体切除术之前和术后 10 周通过联合施用四种释放激素（垂体前叶）、施用氟哌啶醇（中间部）和输注高渗盐水（垂体后叶）。结果 - CT 成像能够实现垂体的准确术前定位。适当的定位和手术技术有助于暴露垂体并在不出血的情况下将其取出。术后恢复一般并不复杂。这八只狗都没有生长激素。垂体切除术后 10 周，促性腺激素、促泌乳激素、促黑素激素或垂体后叶对刺激的反应。在联合垂体前叶功能测试中，四只狗（ACTH 无反应者）也没有促肾上腺皮质激素反应，四只狗（ACTH 反应者）有不良的小但显着的反应。 ACTH 无反应者的肾上腺皮质萎缩比反应者更明显。沿下丘脑间脑腹侧未发现残留垂体组织，但在蝶鞍纤维组织中发现嵌入垂体细胞巢。结论-手术技术被证明是安全有效的。蝶鞍中的垂体细胞的微观巢可能是垂体切除术后对促垂体刺激的残余促肾上腺皮质反应的原因。临床相关性-手术技术可用于治疗患有垂体依赖性肾上腺皮质功能亢进症的狗。促皮质反应是评估犬垂体切除术完整性的最敏感标准。 (C) 美国兽医学院版权所有 1997。
Objective-Assessment of a microsurgical technique for transsphenoidal hypophysectomy in dogs.Study Design-Prospective study using physical examination, pituitary function testing, computed tomography (CT), and histological examination at autopsy.Animals or Sample Population-Eight laboratory beagle dogs.Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary).Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropic response and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded in fibrous tissue in the sella turcica.Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy.Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons.