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01 奈良県立医科大学 >
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0122 学位請求論文 >
01221 博士論文(医学) >
2022年度 >
Please use this identifier to cite or link to this item:
http://hdl.handle.net/10564/4103
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Title: | Impact of surgical factors on delayed hyponatremia in patients with nonfunctioning pituitary adenoma after endonasal endoscopic transsphenoidal procedure |
Other Titles: | 非機能性下垂体腺腫における経鼻内視鏡下経蝶形骨洞手術後の遅発性低ナトリウム血症の手術因子の検討 |
Authors: | Tanaka, Haku Nishimura, Fumihiko Nakase, Kenta Kakutani, Miho Yokoyama, Shohei Morimoto, Takayuki Kim, Taekyun Young-Soo, Park Nakagawa, Ichiro Yamada, Shuichi Tamura, Kentaro Matsuda, Ryosuke Takeshima, Yasuhiro Kotsugi, Masashi Nakase, Hiroyuki |
Keywords: | Delayed hyponatremia Pituitary adenoma Hypertension Diabetes insipidus Meningitis Endoscopic transsphenoidal surgery |
Issue Date: | Nov-2022 |
Publisher: | Springer |
Citation: | Endocrine Vol.78 No.2 p.354-362 (2022 Nov) |
Abstract: | Purpose Delayed hyponatremia can occur after pituitary surgery, resulting in prolonged hospitalization. However, the
influence of surgical factors after such a procedure has not been well established. The impact of surgery and related factors
on delayed hyponatremia was investigated.
Methods This was a retrospective analysis of 137 consecutive patients who underwent transsphenoidal surgery for a
nonfunctioning pituitary adenoma between 2008 and 2019. Preoperative (demographics, comorbidities), intraoperative
(resection extent, operation time, blood loss volume, cerebrospinal fluid leak, tumor consistency), and postoperative
[hematoma, meningitis, diabetes insipidus (DI), hormonal assessment] data were collected, with statistical analysis of each
factor performed.
Results Among the 137 patients, delayed hyponatremia occurred in 31 (22.6%). Multivariate analysis revealed that those
with hypertension had a significantly higher likelihood of avoiding delayed hyponatremia (p = 0.004). Although no correlations
of direct surgical factors with delayed hyponatremia were found, multivariate analysis of indirect surgical factors
showed that presence of a firm tumor, transient DI, and meningitis were significantly associated with delayed hyponatremia
(p = 0.014, 0.001, and 0.047, respectively). There was also a significant association of severe hyponatremia with appearance
of symptoms (p = 0.002).
Conclusion There was a tendency for hypertension to be associated with delayed hyponatremia avoidance, with indirect
surgical factors including tumor consistency, transient DI, and meningitis found to have an influence on delayed hyponatremia.
It was concluded that attention should be given to non-hypertensive patients with a firm tumor, transient DI, or
meningitis after pituitary surgery, as delayed hyponatremia may occur. |
Description: | 博士(医学)・甲第871号・令和5年3月15日 © The Author(s) 2022
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. |
URI: | http://hdl.handle.net/10564/4103 |
ISSN: | 1355008X |
DOI: | https://doi.org/10.1007/s12020-022-03164-y |
Academic Degrees and number: | 24601甲第871号 |
Degree-granting date: | 2023-03-15 |
Degree name: | 博士(医学) |
Degree-granting institutions: | 奈良県立医科大学 |
Appears in Collections: | 2022年度
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