Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications

International Journal of Endocrinology - Tập 2012 - Trang 1-7 - 2012
Yvette Marquez1, Alexander Tuchman1, Gabriel Zada1
1Department of Neurosurgery, Keck School of Medicine, USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USA

Tóm tắt

Among multimodality treatments for acromegaly, the goals of surgical intervention are to balance maximal tumor resection while preserving normal pituitary function and maintaining patient safety. The resection of growth hormone-(GH-) secreting pituitary adenomas in the hands of experienced surgeons results in hormonal remission in 50–70% of patients. Acromegalic patients often have medical comorbidities and anatomical variations complicating anesthesia and surgical management. Despite these challenges, complications such as CSF leak or new hypopituitarism following surgery remain uncommon. Over the past decade, endoscopic approaches to pituitary tumors have improved visualization and facilitated identification of additional tumor using angled telescopes. Patients with persistent acromegaly following surgery require continued medical and/or radiation-based interventions. The adjunctive use of stereotactic radiosurgery offers hormonal remission in 40–50% of patients. In this article, the current preoperative evaluation, indications for surgery, surgical approaches, role of radiosurgery, complications, and remission criteria following operative resection of GH adenomas are reviewed.

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International Journal of Endocrinology

Tập 2012

1-7

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