Marguth F, Oeckler R
Neurosurg Rev. 1985;8(3-4):221-4. doi: 10.1007/BF01815446.
Based on 880 pituitary adenomas operated upon between 1972 and 1982 the diagnostic and therapeutical strategy in recurrences is discussed. The incidence of reoperations was 7.75%, 3.7% in hormonally inactive and 4.1% in hormonally active recurrences. The rate was 30% after transcranial surgery--due to the extension of the tumours--and 5% after the trans-sphenoidal approach. In hormone inactive adenomas visual impairment in 29 out of 50 recurrences caused a second operation combined with radiotherapy in 13 cases. Radiotherapy alone was used in 17 cases. In hormonally active adenomas the treatment of persistent hormonal excess represents the main therapeutical problem. With HGH-producing adenomas a return to normal was achieved in 22 cases mainly by a combination of reoperation and radiotherapy (12) or radiotherapy (8) alone. Radiotherapy should be avoided in young patients whenever possible. The procedure of choice in PRL-producing adenomas (14 cases) seems to be treatment with dopamine-agonists (9). An additional reoperation was necessary in five cases.
基于1972年至1982年间接受手术治疗的880例垂体腺瘤，讨论了复发时的诊断和治疗策略。再次手术的发生率为7.75%，无激素活性复发者为3.7%，有激素活性复发者为4.1%。经颅手术后的再次手术率为30%（由于肿瘤的扩展），经蝶窦入路后为5%。在无激素活性的腺瘤中，50例复发中有29例出现视力障碍，其中13例再次手术并联合放疗，17例仅采用放疗。在有激素活性的腺瘤中，持续性激素分泌过多的治疗是主要的治疗问题。在生长激素分泌型腺瘤中，22例主要通过再次手术与放疗联合（12例）或仅放疗（8例）恢复正常。尽可能避免对年轻患者进行放疗。在泌乳素分泌型腺瘤（14例）中，首选的治疗方法似乎是使用多巴胺激动剂（9例），5例需要再次手术。
