■主要目的是根据第11号肢端肥大症共识声明(2018)分析短期和两年随访中的鼻内镜手术结果。的确,分析预后因素及并发症。
■分析了2013年至2020年期间接受鼻内镜手术并肢端肥大症的40例患者。如果在六个月和两年的随访中正常(ULN)IGF-1的上限小于1.0,则认为患者处于缓解状态。此外,我们评估了Knosp等级,肿瘤体积学,ULN,MRI中的T2信号,再操作,和并发症。
■入院平均年龄为46.7岁。32例患者在手术6个月后缓解(80%),在两年的随访中下降到76.32%。所有微腺瘤均缓解(n=6)。关于并发症,3例患者出现永久性全垂体功能减退症(7.5%);本系列中没有发生术后脑脊液(CSF)渗漏.在多因素Logistic回归分析中,T2MRI上的高信号和较高的肿瘤体积是不发射的单一预测因素(p<0.05)。术前激素水平(GH和IGF-1)不是缓解的预后因素。出现超信号的再次手术患者已经具有很高的临床手术失败预测因子。
■鼻内镜手术可促进肢端肥大症的短期和两年高缓解率;在非缓解患者中,肿瘤体积和T2高信号是有统计学意义的预后因素——与文献相比,并发症发生率相似。在侵袭性GH分泌肿瘤中,我们应该为这些患者提供多学科的方法来提高肢端肥大症患者的缓解率。
UNASSIGNED: The primary aim is to analyze the endoscopic endonasal surgical results in short-term and two-year follow-ups according to the 11th Acromegaly
Consensus statement (2018). Indeed, prognostic factors and complications were analyzed.
UNASSIGNED: 40 patients who underwent endoscopic endonasal surgery by acromegaly between 2013 to 2020 was analyzed. Patients were considered in remission if an upper limit of normal (ULN) IGF-1 was less than 1.0 at the six-month and two-year follow-ups. Moreover, we assessed the Knosp grade, tumor volumetry, ULN, T2 signal in MRI, reoperation, and complications.
UNASSIGNED: The mean age of admission was 46.7 years. Thirty-two patients were in remission after six months of surgery (80%), decreasing to 76.32% at the two-year follow-up. All microadenomas presented remission (n = 6). Regarding the complications, three patients had permanent panhypopituitarism (7.5%); postoperative cerebrospinal fluid (CSF) leaks did not occur in this series. The hyperintense signal on the T2 MRI and a higher tumor volumetry were the single predictor\'s factors of non-emission in a multivariate regression logistic analysis (p < 0.05). Preoperative hormone levels (GH and IGF-1) were not a prognostic factor for remission. The re-operated patients who presented hypersignal already had a high predictor of clinical-operative failure.
UNASSIGNED: The endoscopic endonasal surgery promotes high short-term and two-year remission rates in acromegaly; the tumor\'s volumetry and the T2 hypersignal were statistically significant prognostic factors in non-remission - the complications presented at similar rates in comparison to the literature. In invasive GH-secreting tumors, we should offer these patients a multi-disciplinary approach to improve acromegalic patients\' remission rates.