Risk Factors for Postoperative Diabetes Insipidus Following Endonasal Sellar/Parasellar Tumor Resection: Does Timing of Postoperative Administration Predict Long-Term Need?

Background: Diabetes insipidus is a common complication following sellar or parasellar surgery involving the pituitary gland. Although this is fairly transient and typically has an onset within 24 to 48 hours of surgery, it is unclear if the postoperative timing of the need for desmopressin administration is predictive of long-term replacement.

Methods: We reviewed 81 consecutive patients undergoing endoscopic endonasal surgery for sellar/parasellar pathology involving the pituitary gland or infundibulum. Data evaluated included age, gender, pathology, sellar versus suprasellar origin of pathology, tumor size, Knosp grade, preoperative visual status, intraoperative CSF leak, timing of desmopressin dosing, other postoperative endocrinopathies.

Results: Thirty patients (37%) required at least one dose of desmopressin at some point during their postoperative course. Only 13 patients (16%) required desmopressin on hospital discharge, and 12 of the 13 remained on replacement at last follow-up while 1 additional patient required long-term desmopressin initiation after discharge. The most predictive variable for long-term desmopressin need was initial dosing within 12 hours of completion of the surgical procedure (p < 0.05)

Conclusion: Postoperative diabetes insipidus following EEA resection of sellar and parasellar tumors can be common and a potentially serious complication. The need for desmopressin administration within 12 hours postoperatively is high predictive of the need for long-term treatment.

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Artikel online veröffentlicht:
05. Februar 2024