surgery and radiosurgery for acromegaly a review of indications, operative techniques, outcomes, and complications为肢端肥大症手术和放射治疗的适应症、手术技术、结果和并发症.pdfVIP

Hindawi Publishing Corporation International Journal of Endocrinology Volume 2012, Article ID 386401, 7 pages doi:10.1155/2012/386401 Review Article Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications Yvette Marquez, Alexander Tuchman, and Gabriel Zada Department of Neurosurgery, Keck School of Medicine, USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USA Correspondence should be addressed to Yvette Marquez, ydma7@ Received 16 October 2011; Accepted 21 December 2011 Academic Editor: Furio M. Pacini Copyright © 2012 Yvette Marquez et al. 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. 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 inter