Zheng Yong, Chen Dong-Ming, Wang Yan, Mai Rong-Kang, Zhu Zi-Feng
Neurosurgery Department.
Geriatrics Department, The Second Affiliated Hospital of Shenzhen University (People's Hospital of Shenzhen Baoan District), Shenzhen, Guangdong, China.
Medicine (Baltimore). 2020 May;99(19):e19855. doi: 10.1097/MD.0000000000019855.
The endoscopic endonasal transsphenoidal approach (EETA) is the primary treatment for growth hormone (GH) adenoma. This study aimed to investigate the outcomes of EETA in 33 patients with GH-secreting pituitary adenoma (PA).Thirty-three patients who underwent EETA in Eighth People's Hospital of Shenzhen between January 2013 and December 2017 were included in the comprehensive analysis. Factors affecting the extent of resection and postoperative remission rates were also reviewed.The total cut rate was 63.6% (21), and the total remission rate was 66.7% (22) in all patients after surgery. The cure rate was 60.6% (20) for 33 patients. The total removal rate and remission rate were significantly different (P = .01, P = .007) for microadenomas, macroadenomas, and giant adenomas. In addition, the total removal rate and remission rate were significantly different (P = .004, P = .007) for patients with noninvasive and invasive GH-secreting PAs. Furthermore, there were significant differences (P = .003, P = .005) in the total removal rate and remission rate of patients with different preoperative GH levels. All patients with hypertension and diabetes mellitus were normalized. Three patients exhibited recurrence after surgery. Several patients suffered from postoperative complications, including transient diabetes insipidus in 3 (9.1%) patients and postoperative transient cerebrospinal fluid leakage in 2 (6.1%) patients.EETA is an effective therapeutic approach for treating patients with GH-secreting PA with high remission and low complication rates. Therefore, EETA should be considered a primary treatment for patients with GH-secreting PA.
鼻内镜下经蝶窦入路（EETA）是生长激素（GH）腺瘤的主要治疗方法。本研究旨在探讨EETA治疗33例分泌GH的垂体腺瘤（PA）的疗效。纳入2013年1月至2017年12月在深圳市第八人民医院接受EETA治疗的33例患者进行综合分析。同时回顾影响切除范围和术后缓解率的因素。所有患者术后全切率为63.6%（21例），总缓解率为66.7%（22例）。33例患者的治愈率为60.6%（20例）。微腺瘤、大腺瘤和巨大腺瘤的全切率和缓解率有显著差异（P = 0.01，P = 0.007）。此外，非侵袭性和侵袭性分泌GH的PA患者的全切率和缓解率有显著差异（P = 0.004，P = 0.007）。此外，不同术前GH水平患者的全切率和缓解率也有显著差异（P = 0.003，P = 0.005）。所有高血压和糖尿病患者病情均恢复正常。3例患者术后复发。部分患者出现术后并发症，包括3例（9.1%）患者出现短暂性尿崩症，2例（6.1%）患者出现术后短暂性脑脊液漏。EETA是治疗分泌GH的PA患者的有效治疗方法，缓解率高且并发症发生率低。因此，EETA应被视为分泌GH的PA患者的主要治疗方法。
