Delayed Postoperative Hyponatremia Following Endoscopic Transsphenoidal Surgery for Non-Adenomatous Parasellar Tumors
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Baseline Characteristics
2.2. Symptomatic and Serological DPH
2.3. Detailed Course of Sodium Levels
2.4. Risk Factors Associated with DPH
2.5. Other Electrolytic and Endocrinological Abnormalities
3. Discussion
4. Materials and Methods
4.1. Patient Selection
4.2. Surgical Procedure
4.3. Postoperative Management
4.4. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Value | |
---|---|---|
Median age, years (range) | 47 (19–85) | |
Median preoperative sodium level, mmol/L (range) | 141 (136–148) | |
Median tumor diameter, mm (range) | 31 (15–48) | |
Male sex, n (%) | 12 (40) | |
Comorbidity *, n (%) | ACTH-deficiency | 0 (0) |
DM | 2 (6) | |
HL | 3 (10) | |
HTN | 7 (23) | |
Pathological diagnosis, n (%) | Chordoma | 15 (50) |
Meningioma | 8 (27) | |
Chondrosarcoma | 5 (17) | |
Neurenteric cyst | 1 (3) | |
Neurinoma | 1 (3) | |
Previous intervention, n (%) | Resection | 10 (32) |
Radiotherapy | 5 (16) | |
Location *, n (%) | Sellar region | 10 (33) |
Cavernous sinus | 19 (63) | |
Suprasellar region | 11 (37) | |
Dorsum sellae | 19 (63) | |
Sphenoid sinus | 3 (10) | |
Petrous apex | 12 (40) | |
Clivus | 22 (73) | |
Anterior skull base | 4 (13) | |
Posterior fossa (intradural) | 12 (40) | |
Third ventricle | 0 (0) |
No. | Age, Sex | Dx | Main Location | Extradural Retraction * | Contact to Stalk | Serum Sodium Level (mmol/L) | Body Weight (kg) | Hematocrit (%) | Symptomatic Hyponatremia | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pre | Phase 1 | Phase 2 | Phase 3 | Δ ** | Pre | Phase 3 | Δ% † | Phase 1 | Phase 3 | Δ% ‡ | |||||||
1 | 70, F | Mgm | Ptcl | Yes | No | 139 | 138 | 140 | 112 | −27 | 54.4 | 57.3 | 5.4 | 38.2 | 36.1 | −5.5 | Yes |
2 | 69, F | Cho | Cli | Yes | No | 140 | 143 | 144 | 123 | −17 | 51.0 | 49.2 | −3.6 | 26.2 | 27.1 | +3.4 | Yes |
3 | 38, F | Cho | Cli | Yes | No | 140 | 139 | 140 | 126 | −14 | 84.3 | 86.3 | 2.4 | 29.9 | 30.1 | +0.3 | Yes |
4 | 75, F | Mgm | ITF-Sph | Yes | No | 142 | 141 | 144 | 130 | −12 | 43.2 | 43 | −0.5 | 25.1 | 31.8 | +26.7 | Yes |
5 | 58, F | Mgm | TS | No | Yes | 141 | 146 | 147 | 130 | −11 | 53.1 | 57.2 | 7.7 | 29.5 | 25.4 | −13.9 | No |
6 | 55, F | Mgm | Ptcl | Yes | No | 142 | 139 | 142 | 134 | −8 | 60.2 | 57.7 | −4.2 | 26.3 | 24.7 | −6.1 | No |
7 | 59, M | Chs | PA-PF | Yes | No | 141 | 140 | 136 | 135 | −6 | 76.7 | 71.4 | −6.9 | 37.7 | 43.6 | +15.6 | No |
8 | 34, M | Cho | DS | Yes | No | 137 | 143 | 143 | 134 | −3 | 83.0 | 77.6 | −6.5 | 38.8 | 44.1 | +13.7 | No |
Clinical Course | Median Serum Sodium Level (Range), mmol/L | |||
---|---|---|---|---|
Pre | Phase 1 | Phase 2 | Phase 3 | |
No DPH | 141 | 142 | 143 | 141 |
(136–148) | (136–145) | (136–148) | (136–143) | |
Asymptomatic DPH | 141 | 142 | 143 | 134 |
(137–142) | (139–146) | (136–147) | (130–135) | |
Symptomatic DPH | 140 | 140 | 142 | 125 |
(139–142) | (138–143) | (140–144) | (112–130) |
Variables | Symptomatic DPH | Serologic DPH | |||
---|---|---|---|---|---|
p Value | OR (95%CI) | p Value | OR (95%CI) | ||
Age (cont.) | 0.098 | 0.94 (0.86–1.01) * | 0.124 | 0.96 (0.91–1.01) * | |
Preoperative sodium level (cont.) | 0.749 | 1.09 (0.65–1.82) * | 0.624 | 1.10 (0.74–1.64) * | |
Tumor diameter (cont.) | 0.206 | 0.93 (0.83–1.04) * | 0.413 | 0.97 (0.89–1.05) * | |
Male sex | 0.120 | 0.13 (0.01–2.64) | 0.419 | 0.40 (0.07–2.44) | |
Comorbidity | Diabetes mellitus | 1.000 | 1.09 (0.04–26.67) | 1.000 | 0.48 (0.02–11.14) |
Hyperlipidemia | 0.454 | 2.88 (0.31–26.44) | 0.284 | 3.33 (0.38–28.96) | |
Hypertension | 1.000 | 1.68 (0.20–14.09) | 0.645 | 1.50 (0.22–10.36) | |
Previous intervention | Surgery | 0.270 | 0.15 (0.01–3.07) | 0.199 | 0.17 (0.02–1.64) |
Radiotherapy | 0.557 | 0.35 (0.02–7.41) | 1.000 | 0.49 (0.05–4.94) | |
Location | Sella | 0.095 | 8.14 (0.72–91.89) | 1.000 | 1.29 (0.24–6.96) |
Cavernous sinus | 0.268 | 6.68 (0.33–136.79) | 1.000 | 0.95 (0.18–5.08) | |
Suprasellar region | 1.000 | 0.53 (0.05–5.86) | 0.972 | 0.48 (0.08–2.95) | |
Dorsum sellae | 0.268 | 6.68 (0.33–136.79) | 0.672 | 2.08 (0.34–12.72) | |
Sphenoid sinus | 0.360 | 4.00 (0.27–58.56) | 0.166 | 7.00 (0.54–91.11) | |
Petrous apex | 0.632 | 0.45 (0.04–4.98) | 1.000 | 0.87 (0.16–4.58) | |
Clivus | 1.000 | 1.11 (0.10–12.47) | 1.000 | 1.13 (0.18–7.19) | |
Anterior skull base | 1.000 | 0.56 (0.03–12.24) | 1.000 | 0.90 (0.08–10.21) | |
Posterior fossa (intradural) | 0.130 | 0.13 (0.01–2.64) | 0.433 | 0.40 (0.07–2.44) | |
Extradural retraction of the gland | 0.100 | 12.13 (0.59–248.50) | 0.035 ** | 12.25 (1.27–118.36) | |
Physical contact with the stalk | 1.000 | 0.43 (0.02–9.34) | 1.000 | 0.64 (0.06–6.80) |
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Hasegawa, H.; Shin, M.; Makita, N.; Shinya, Y.; Kondo, K.; Saito, N. Delayed Postoperative Hyponatremia Following Endoscopic Transsphenoidal Surgery for Non-Adenomatous Parasellar Tumors. Cancers 2020, 12, 3849. https://0-doi-org.brum.beds.ac.uk/10.3390/cancers12123849
Hasegawa H, Shin M, Makita N, Shinya Y, Kondo K, Saito N. Delayed Postoperative Hyponatremia Following Endoscopic Transsphenoidal Surgery for Non-Adenomatous Parasellar Tumors. Cancers. 2020; 12(12):3849. https://0-doi-org.brum.beds.ac.uk/10.3390/cancers12123849
Chicago/Turabian StyleHasegawa, Hirotaka, Masahiro Shin, Noriko Makita, Yuki Shinya, Kenji Kondo, and Nobuhito Saito. 2020. "Delayed Postoperative Hyponatremia Following Endoscopic Transsphenoidal Surgery for Non-Adenomatous Parasellar Tumors" Cancers 12, no. 12: 3849. https://0-doi-org.brum.beds.ac.uk/10.3390/cancers12123849