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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/4103

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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