Zhou Tao, Wang Fuyu, Meng Xianghui, Ba Jianmin, Wei Shaobo, Xu Bainan
Department of Neurosurgery, General Hospital of People's Liberation Army, Beijing, China.
Department of Endocrinology, General Hospital of People's Liberation Army, Beijing, China.
J Korean Neurosurg Soc. 2014 Nov;56(5):405-9. doi: 10.3340/jkns.2014.56.5.405. Epub 2014 Nov 30.
To determine the efficacy of endoscopic surgery in combination with long-acting somatostatin analogues (SSAs) in treating patients with growth hormone (GH)-secreting pituitary tumor.
We performed retrospective analysis of 133 patients with GH producing pituitary adenoma who underwent pure endoscopic transsphenoidal surgery in our center from January 2007 to July 2012. Patients were followed up for a range of 3-48 months. The radiological remission, biochemical remission and complication were evaluated.
A total of 110 (82.7%) patients achieved radiological complete resection, 11 (8.2%) subtotal resection, and 12 (9.0%) partial resection. Eighty-eight (66.2%) patients showed nadir GH level less than 1 ng/mL after oral glucose administration. No mortality or severe disability was observed during follow up. Preoperative long-acting SSA successfully improved left ventricle ejection fraction (LVEF) and blood glucose in three patients who subsequently underwent success operation. Long-acting SSA (20 mg every 30 days) achieved biochemical remission in 19 out 23 (82.6%) patients who showed persistent high GH level after surgery.
Endoscopic transsphenoidal surgery can biochemically cure the majority of GH producing pituitary adenoma. Post-operative use of SSA can improve biochemical remission.
确定内镜手术联合长效生长抑素类似物（SSAs）治疗生长激素（GH）分泌型垂体瘤患者的疗效。
我们对2007年1月至2012年7月在本中心接受单纯内镜经蝶窦手术的133例生长激素分泌型垂体腺瘤患者进行了回顾性分析。对患者进行了3至48个月的随访。评估了影像学缓解、生化缓解及并发症情况。
共有110例（82.7%）患者实现影像学完全切除，11例（8.2%）次全切除，12例（9.0%）部分切除。88例（66.2%）患者口服葡萄糖后生长激素最低水平低于1 ng/mL。随访期间未观察到死亡或严重残疾情况。术前长效SSA成功改善了3例随后手术成功患者的左心室射血分数（LVEF）和血糖。长效SSA（每30天20 mg）使23例术后生长激素水平持续升高患者中的19例（82.6%）实现生化缓解。
内镜经蝶窦手术可使大多数生长激素分泌型垂体腺瘤获得生化治愈。术后使用SSA可提高生化缓解率。
