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

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...

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Detalles Bibliográficos
Autores principales: Marquez, Yvette, Tuchman, Alexander, Zada, Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303541/
https://www.ncbi.nlm.nih.gov/pubmed/22518121
http://dx.doi.org/10.1155/2012/386401
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author Marquez, Yvette
Tuchman, Alexander
Zada, Gabriel
author_facet Marquez, Yvette
Tuchman, Alexander
Zada, Gabriel
author_sort Marquez, Yvette
collection PubMed
description 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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spelling pubmed-33035412012-04-19 Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications Marquez, Yvette Tuchman, Alexander Zada, Gabriel Int J Endocrinol Review Article 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. Hindawi Publishing Corporation 2012 2012-03-01 /pmc/articles/PMC3303541/ /pubmed/22518121 http://dx.doi.org/10.1155/2012/386401 Text en Copyright © 2012 Yvette Marquez et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Marquez, Yvette
Tuchman, Alexander
Zada, Gabriel
Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications
title Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications
title_full Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications
title_fullStr Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications
title_full_unstemmed Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications
title_short Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications
title_sort surgery and radiosurgery for acromegaly: a review of indications, operative techniques, outcomes, and complications
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303541/
https://www.ncbi.nlm.nih.gov/pubmed/22518121
http://dx.doi.org/10.1155/2012/386401
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