Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Horizon Therapeutics, Lake Forest, USA.
Curr Rheumatol Rep. 2020 Nov 24;23(1):1. doi: 10.1007/s11926-020-00969-6.
Medical treatment with urate-lowering therapy (ULT) is efficacious. A recent publication suggested that surgery in gout is more prevalent than previously reported. This revelation led us to review what is known about surgical treatment of gout.
The Google Scholar database (January 1, 2014-January 1, 2020) found 104 publications with a total of 169 gout patients, with an average disease duration of 6.7 years. Most (68%) were not on ULT. The mean pre-operative serum urate levels were 9.19 mg/dL. One hundred thirteen patients underwent tophi excision, while in 33 patients, tophi were found during surgery. The majority of the surgeries were performed in Asia and Europe. Most patients were not taking ULT at the time of surgery, leading to hyperuricemia. This can result in tophi reformation post-surgery. The role of surgery should be a last-line treatment and until recently has only been demonstrated through case reports.
降低尿酸治疗（ULT）的医学治疗是有效的。最近的一篇出版物表明，痛风手术比以前报道的更为普遍。这一发现促使我们回顾了关于痛风手术治疗的已知情况。
通过谷歌学术数据库（2014 年 1 月 1 日至 2020 年 1 月 1 日）检索到 104 篇出版物，共计 169 例痛风患者，平均病程为 6.7 年。大多数（68%）患者未接受 ULT。术前血清尿酸水平平均为 9.19mg/dL。113 例患者行痛风石切除术，33 例患者术中发现痛风石。大多数手术在亚洲和欧洲进行。大多数患者在手术时未接受 ULT，导致高尿酸血症。这可能导致手术后痛风石再次形成。手术的作用应是最后的治疗方法，直到最近才仅通过病例报告得到证实。
