Outcomes of Acromegaly Patients Treated with Sandostatin LAR after Surgical Excision of Pituitary Adenoma

Muhammad Naveed Majeed, Sumira Kiran, Muhammad Kaleem Iftikhar, Ch. Arslan Ahmad, Khawar Anwar
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Abstract

Objectives:  An observational study to evaluate the outcomes of Acromegaly patients treated in the department of Neurosurgery III, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan. Materials and Methods:  This study was the analysis of a case series of 20 patients (mean age: 30 years) of both genders with acromegaly due to macroadenoma who had endonasal excision and postoperative treatment with Sandostatin LAR. Results:  This study consisted of a total of 20 patients out of which 11 (55%) were male and 9 (45%) were female. All 20 Patients (100%) had a headache as their main symptom and 13 patients (65%) had visual field deterioration. 19 patients (95%) had complete resection of the tumor whereas 1 (5%) had a subtotal resection. After surgery and treatment growth hormone levels improved in 19 patients (95%) and remained elevated in 1 patient (5%), IGF-1 (Insulin-like growth factor – 1) levels improved in all 20 (100%) patients. Following consecutive octreotide injections vision of 11 patients (84%) out of 13 improved and in 2 (16%) patients, it remained the same as of Preoperative status whereas Headache improved in all 20 (100%) of the patients. None of the patients had any complications related to the procedure or the injection of octreotide LAR. Conclusion:  Acromegaly due to macroadenoma responds well to treatment with octreotide LAR after endonasal resection in terms of hormonal levels and symptoms of the patients. It is a safe treatment with very less side effects and complications.
肢端肥大症患者垂体腺瘤切除术后应用山多他汀LAR治疗的疗效
目的:一项观察性研究,评估在巴基斯坦拉合尔旁遮普省神经科学研究所神经外科III科治疗肢端肥大症患者的疗效。材料和方法:本研究分析了20例(平均年龄:30岁)因大腺瘤引起的肢端肥大症患者的病例系列,这些患者均行鼻内切除术并术后使用山多他汀LAR治疗。结果:本研究共纳入20例患者,其中男性11例(55%),女性9例(45%)。20例(100%)患者以头痛为主要症状,13例(65%)患者视野恶化。19例患者(95%)完全切除肿瘤,1例(5%)次全切除肿瘤。手术和治疗后,19例(95%)患者的生长激素水平改善,1例(5%)患者的生长激素水平保持升高,所有20例(100%)患者的IGF-1(胰岛素样生长因子-1)水平改善。连续注射奥曲肽后,13例患者中有11例(84%)患者的视力得到改善,2例(16%)患者的视力与术前相同,而所有20例(100%)患者的头痛均得到改善。所有患者均无任何与手术或奥曲肽LAR注射相关的并发症。结论:大腺瘤所致肢端肥大症患者在鼻内切除术后接受奥曲肽LAR治疗,在激素水平和症状方面效果良好。这是一种安全的治疗方法,副作用和并发症很少。
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