Importance of Intraoperative Factors in Postoperative Arginine Vasopressin Deficiency After Pituitary Adenoma Surgery
Authors' conclusion
The reported incidence of AVP-D has a considerably wide range. A consistent definition and grading for AVP-D will increase consistency and comparability among studies. Nonetheless, most patients experience AVP-D on a temporary basis, and only a few require long-term treatment. Cerebrospinal fluid leak, gross total resection, and hormonal remission were identified as risk factors for postoperative AVP-D. We believe that the intraoperative risk factors play the main role in postoperative AVP-D. The course of surgery and operative findings help us plan selective postoperative patient monitoring and care.
Study context
- Population
- Patients who underwent endoscopic transsphenoidal surgery for pituitary adenomas
- Participants
- 520 patients
- Outcome
- Incidence of postoperative AVP-D (early, transient, permanent) and associated risk factors
Main finding
As reported in the abstract
Early arginine vasopressin deficiency (AVP-D)
24.8%
Transient AVP-D
1.9%
n = 10
Permanent AVP-D
1.1%
6 patients
Observational data: associations, not effects.
Further findings
Risk factors associated with higher incidence of AVP-D
- Gross total resection
- P = 0.027
- Hormonal remission
- P = 0.002
- Pituitary stalk manipulation
- P < 0.001
- Intraoperative cerebrospinal fluid leak
- P < 0.001
- AVP-D not related to tumor size
- All patients with permanent AVP-D had somatotroph adenomas
LOS
- LOS prolonged by AVP-D on average (days)
- 1.5 (P = .018)
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →