Transsphenoidal Surgery for Elderly Patients with Acromegaly and Its Outcomes: Comparison with Younger Patients
Autor: | Yasuhiko Hayashi, Masahiro Oishi, Hideaki Iizuka, Atsushi Nakagawa, Yasuo Sasagawa, Toshinari Takamura, Osamu Tachibana, Mitsutoshi Nakada |
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Rok vydání: | 2018 |
Předmět: |
Adenoma
Adult Male medicine.medical_specialty Sphenoid Sinus medicine.medical_treatment 030209 endocrinology & metabolism Neurosurgical Procedures Cohort Studies 03 medical and health sciences 0302 clinical medicine Pituitary adenoma Diabetes mellitus Acromegaly Humans Medicine Pituitary Neoplasms Surgical treatment Aged Retrospective Studies Transsphenoidal surgery business.industry Perioperative Middle Aged medicine.disease humanities Surgery Treatment Outcome Female Neurology (clinical) Tumor removal business 030217 neurology & neurosurgery Follow-Up Studies American society of anesthesiologists |
Zdroj: | World Neurosurgery. 118:e229-e234 |
ISSN: | 1878-8750 |
Popis: | Elderly patients with acromegaly who have comorbidities may increasingly encounter perioperative complications; however, little data are available on the risks and outcomes of surgical treatment in these patients. We aimed to analyze and compare the results of transnasal transsphenoidal surgery (TTS) in elderly and younger patients.Eighty-seven consecutive patients with acromegaly who underwent TTS were included. We divided the patients into elderly (≥65 years) and younger (65 years) groups and compared clinical characteristics, anesthesia risk, and surgical outcomes in these 2 groups.The 87 patients included 24 (27.6%) in the elderly group and 63 (73.4%) in the younger group. Preoperative endocrinologic and radiologic assessments showed no significant differences between the 2 groups. Although a grade 3 American Society of Anesthesiologists Physical Status classification was more common in the elderly group (75% vs. 3%; P = 0.00001) owing to the severity of associated diseases, no significant between-group difference in perioperative complications was seen (17% vs. 6%; P = 0.142). Sixteen elderly patients and 45 younger patients achieved endocrinologic remission following surgery (67% vs. 71%; P = 0.426). The incidence rate of postoperative new pituitary deficit was similar in the elderly and younger groups (4% vs. 3%; P = 0.625). Approximately one-third of the elderly patients with diagnosed hypertension or diabetes mellitus tapered their medication after successful tumor removal.TTS can be considered a safe treatment for both younger and elderly patients with acromegaly. Successful tumor removal provided a significant improvement in comorbidities even in elderly patients with acromegaly. |
Databáze: | OpenAIRE |
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