Evidence supporting surgery as treatment of choice for acromegaly.
Evidence supporting surgery as treatment of choice for acromegaly.
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有证据支持手术作为肢端肥大症的首选治疗方法。
DOI：
10.1677/joe.0.155s053
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发表时间：
1997
影响因子：
4
通讯作者：
M. Buchfelder
中科院分区：
文献类型：
--
作者：
R. Fahlbusch;J. Honegger;M. Buchfelder
在14年的时间内，进行了531例生长激素（GH）分泌腺瘤手术。在这个连续的系列中，396例接受初次经蝶手术的患者中有73%的患者基础GH水平低于5微克/升，58%的患者在口服葡萄糖耐量试验（OGTT）后也有足够的抑制。在初始治疗后需要手术的患者中发现了略差的结果。然而，41%的121例这样的患者，无论是以前做过手术或谁接受外部或内部照射，但达到基础GH水平低于5微克/升手术后再次介入。23%的患者在OGTT期间观察到血清GH正常抑制。总体并发症发生率低，肿瘤复发非常罕见。为了使肿瘤切除更容易，奥曲肽在53例接受大腺瘤初次手术的患者中术前给药。在少数例外情况下记录了复发。这些数据支持我们以前的经验，即一旦垂体腺瘤手术后生长激素正常抑制，长期结果是有利的。
Within a period of fourteen years 531 operations for growth hormone (GH)-secreting adenomas were carried out. In this consecutive series 73% of the 396 patients who underwent primary transsphenoidal surgery achieved basal GH levels below 5 micrograms/l, and 58% also had an adequate suppression following an oral glucose tolerance test (OGTT). Slightly less favourable results were found in patients requiring surgery following an initial therapy. However, 41% of 121 such patients, who had either been operated upon previously or who had received external or internal irradiation, nevertheless achieved basal GH levels below 5 micrograms/l after the surgical reintervention. Normal suppression of serum GH during an OGTT was observed in 23% of these patients. The overall complication rate was low and tumour recurrences were very rare. To facilitate easier tumour removal, octreotide was preoperatively administered in 53 patients undergoing primary surgery of large adenomas. Recurrences were documented in a few exceptional cases. These data support our previous experience that once a normal suppression of growth hormone has been documented following surgery of pituitary adenomas, the long-term outcome is favourable.