Real-life analysis of 280 patients with surgically treated acromegaly: a single-center experience from 2008 to 2015
| Autor: | Amir-Hossein Rahvar, Jakob Matschke, Kara Krajewski, Jens Aberle, Till Burkhardt, Marius Marc-Daniel Mader, Roman Rotermund, Jörg Flitsch |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Single Center 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Time frame Postoperative Complications Acromegaly medicine Humans Csf leakage Child Aged Retrospective Studies Transsphenoidal surgery Aged 80 and over business.industry Remission Induction General Medicine Perioperative Middle Aged medicine.disease Surgery Treatment Outcome Diabetes insipidus Female Neurology (clinical) business Hyponatremia 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neurosurgical focus. 48(6) |
| ISSN: | 1092-0684 |
| Popis: | OBJECTIVEThe purpose of this study was to analyze the clinical and biochemical outcome of consecutive patients with acromegaly after microscopic transsphenoidal surgery (MTS) at a single center over an 8-year period.METHODSA retrospective analysis of patients with acromegaly treated via MTS between 2008 and 2015 at the authors’ center was performed. The mean follow-up was 29 months (range 1–120 months). Parameters investigated included tumor size, pre- and postoperative insulin-like growth factor–I, growth hormone levels, pretreatment, perioperative complications, and clinical outcome.RESULTSA total of 280 patients with acromegaly were treated surgically at the authors’ center over the abovementioned time frame and were included in analyses. For 231 of these patients, complete follow-up data were available for evaluation. One hundred eighty-eight patients (81%) showed remission initially according to current criteria. So far, 23 of these patients relapsed in the further course, so that on follow-up 165 patients (71%) demonstrated full remission by surgery alone. Most patients in whom remission after surgery failed were treated with somatostatin receptor ligands and/or dopamine agonists as second-line treatment. The main postoperative complications included transient hyponatremia and diabetes insipidus (13/280; 4.6%). CSF leakage only occurred in 2 cases (2/280; 0.7%). No surgery-related death occurred.CONCLUSIONSThe data underline the effectiveness of MTS in acromegaly. Many patients with recurrent disease or incomplete tumor resection can be successfully managed pharmacologically. |
| Databáze: | OpenAIRE |
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