Document Detail


Outcome of surgery for acromegaly performed by different surgeons: importance of surgical experience.
MedLine Citation:
PMID:  16195777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The aim of this study was to evaluate transsphenoidal surgery results in acromegalic patients which were performed not by a single surgeon but by different surgeons. METHODS: The study included 30 (M/F: 13/17) patients whose follow-up data were available. Basal or nadir postglucose growth hormone levels of less than 2 ng/ml were accepted as cure criteria. Six of them underwent a further operation due to previous surgical failure. RESULTS: Cure was achieved in 33% of patients while hypopituitarism was observed in 10% (3/30) of patients after the first operation. The cure rates were 63% and 15% in patients with microadenomas (n = 11) and macroadenomas (n = 19) respectively (p = 0.042). Only one of the patients (16%) who underwent a second operation achieved remission, while hypopituitarism was observed in five of them (83%). There was no significant difference in the cure rates between the first and second operation, but the risk of hypopituitarism was significantly higher in patients who underwent further surgery (p = 0.008). CONCLUSION: The cure rate following surgery is significantly lower in acromegalic patients with macroadenomas than in patients with microadenomas. Cure probability decreases with a further operation, while complication risk increases significantly. Octreotide therapy, which could be used as an alternative therapy to the surgery, revealed high success rates in both microadenomas and macroadenomas. The low cure rates found in this study compared with published series could be attributed to the fact that operations were performed by inexperienced surgeons.
Authors:
Erdinc Erturk; Ercan Tuncel; Sinem Kiyici; Canan Ersoy; Cevdet Duran; Sazi Imamoglu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pituitary     Volume:  8     ISSN:  1386-341X     ISO Abbreviation:  Pituitary     Publication Date:  2005  
Date Detail:
Created Date:  2006-02-27     Completed Date:  2006-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-7     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Uludag University, School of Medicine, 16059, Bursa, Turkey. ererturk@uludag.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / drug therapy,  surgery*
Adenoma / drug therapy,  surgery
Adult
Clinical Competence
Female
Human Growth Hormone / blood
Humans
Male
Middle Aged
Octreotide / therapeutic use
Pituitary Neoplasms / drug therapy,  surgery
Reoperation
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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