PDF(Pubmed)
Abstract：
Somatotropinomas are the main cause of acromegaly. Surgery is the primary and most efficient method of treatment. The study aimed to compare the radicality of small-sized and medium (<30 mm) somatotropinoma removal and the incidence of postoperative complications in patients with acromegaly when using microscopic and endoscopic techniques.
In this randomized controlled trial, a total of 83 patients with acromegaly underwent transspheroidal endoscopy or microscopic surgery. Somatotropinoma was the cause of acromegaly in all cases. Patients were randomly divided into two comparison groups depending on the applied surgical technique. Group 1 (n = 40) consisted of patients who underwent adenomectomy with transnasal transsphenoidal access by a microscope. Group 2 (n = 43) included patients who underwent the same surgical procedure with an endoscope. The following indicators were assessed: radicality of tumor removal, treatment effectiveness, postoperative complications, and remission rate.
The study has shown that removal of somatotropinoma in patients with acromegaly using endoscopic technique increases the radicality of tumor removal in comparison with microscopic technique. Total removal of somatotropinoma was successful in 88.4% of cases when using the endoscopic technique. Secondly, the segmentation of patients according to their tumor characteristics poses challenges, primarily owing to the rarity of acromegaly as a disease. The difference between groups was not statistically significant (p=1.02). There were no statistically significant differences in basal GH level and IGF-1 level between groups (p=0.546 and p=0.784, respectively).
Endonasal transsphenoidal endoscopic adenomectomy is proven efficacy, a less traumatic degree, and higher somatotropinoma removal radicality. Both surgical methods lead to disease remission.
In this randomized controlled trial, a total of 83 patients with acromegaly underwent transspheroidal endoscopy or microscopic surgery. Somatotropinoma was the cause of acromegaly in all cases. Patients were randomly divided into two comparison groups depending on the applied surgical technique. Group 1 (n = 40) consisted of patients who underwent adenomectomy with transnasal transsphenoidal access by a microscope. Group 2 (n = 43) included patients who underwent the same surgical procedure with an endoscope. The following indicators were assessed: radicality of tumor removal, treatment effectiveness, postoperative complications, and remission rate.
The study has shown that removal of somatotropinoma in patients with acromegaly using endoscopic technique increases the radicality of tumor removal in comparison with microscopic technique. Total removal of somatotropinoma was successful in 88.4% of cases when using the endoscopic technique. Secondly, the segmentation of patients according to their tumor characteristics poses challenges, primarily owing to the rarity of acromegaly as a disease. The difference between groups was not statistically significant (p=1.02). There were no statistically significant differences in basal GH level and IGF-1 level between groups (p=0.546 and p=0.784, respectively).
Endonasal transsphenoidal endoscopic adenomectomy is proven efficacy, a less traumatic degree, and higher somatotropinoma removal radicality. Both surgical methods lead to disease remission.
摘要：
■促生长素瘤是肢端肥大症的主要病因。手术是主要和最有效的治疗方法。该研究旨在比较使用显微镜和内窥镜技术切除肢端肥大症患者中小型和中型（<30mm）生长激素瘤的根治性和术后并发症的发生率。
■在这项随机对照试验中，共有83例肢端肥大症患者接受了透球内镜或显微手术.在所有情况下，促生长素瘤都是肢端肥大症的原因。根据所应用的手术技术，将患者随机分为两个对照组。第1组（n=40）包括通过显微镜经鼻蝶入路进行腺瘤切除术的患者。第2组（n=43）包括使用内窥镜进行相同外科手术的患者。评估了以下指标：肿瘤切除的根治性，治疗效果,术后并发症,和缓解率。
■研究表明，与显微镜技术相比，使用内窥镜技术切除肢端肥大症患者的生长激素瘤可增加肿瘤切除的普遍性。使用内窥镜技术时，在88.4％的病例中成功清除了生长激素瘤。其次,根据患者的肿瘤特征进行分割提出了挑战，主要是由于肢端肥大症作为一种疾病的罕见。组间差异无统计学意义(p=1.02)。两组间基础GH水平和IGF-1水平无统计学差异（分别为p=0.546和p=0.784）。
■经鼻蝶入路内镜下腺腺瘤切除术已被证实有效，创伤程度较小，和更高的促生长素瘤去除激进性。两种手术方法均导致疾病缓解。
■在这项随机对照试验中，共有83例肢端肥大症患者接受了透球内镜或显微手术.在所有情况下，促生长素瘤都是肢端肥大症的原因。根据所应用的手术技术，将患者随机分为两个对照组。第1组（n=40）包括通过显微镜经鼻蝶入路进行腺瘤切除术的患者。第2组（n=43）包括使用内窥镜进行相同外科手术的患者。评估了以下指标：肿瘤切除的根治性，治疗效果,术后并发症,和缓解率。
■研究表明，与显微镜技术相比，使用内窥镜技术切除肢端肥大症患者的生长激素瘤可增加肿瘤切除的普遍性。使用内窥镜技术时，在88.4％的病例中成功清除了生长激素瘤。其次,根据患者的肿瘤特征进行分割提出了挑战，主要是由于肢端肥大症作为一种疾病的罕见。组间差异无统计学意义(p=1.02)。两组间基础GH水平和IGF-1水平无统计学差异（分别为p=0.546和p=0.784）。
■经鼻蝶入路内镜下腺腺瘤切除术已被证实有效，创伤程度较小，和更高的促生长素瘤去除激进性。两种手术方法均导致疾病缓解。
