Clinical Analysis Of The Factors Contributing To Diabetes Insipidus And Electrolyte Disturbance After Surgeries For Craniopharyngiomas

Objective To analyze clinical factors of diabetes insipidus and electrolyte disturbance in patients undergoing removal of craniopharyngiomas.Methords Fifty-eight cases of craniopharyngiomas in the Affiliate Hospital of Ningxia Med Univ from December 2002 to January 2010 surgically treated were analyzed retrospectively. Univariate analysis was performed using the chi-square test, gender, age, preoperative diabetes insipidus, intraoperative treatment of the pituitary stalk, tumor resection, tumor calcification, postoperative diabetes insipidus, classification of tumor, surgical approach were assessed to investigate the related prognostic factors.Results This group included 58 patients.30 were male, 28 were female. The range of the patient's age was 1~71: the average age was 35 years old. There were 12 teenagers (<18) and 46 adults. All the patients were treated surgically. subfrontal approach was performed in 24 cases, pterion approach was performed in 19 cases, transcallosal transseptal interforniceal was performed in 14 cases, transfrontalbasal approach was performed in 1 cases. 48 patients had total resections and 10 patients had subtotal resections. intraoperative severed of the pituitary stalk was 18 cases, and not severed was 40 cases. The bigger tumor calcification was 19 cases, and the others was 39 cases. the incidence of the preoperative diabetes insipidus and electrolyte disturbances were 17 cases and 9 cases, and the postoperative were 47 cases and 44 cases. postoperative is significantly more frequent than preoperative in patients with craniopharyngioma (P<0.05). The incidence of the postoperative diabetes insipidus and electrolyte disturbance had relationship with preoperative diabetes insipidus, intraoperative treatment of the pituitary stalk, tumor resection, tumor calcification (P<0.05), but had no relationship with gender ang age(P>0.05). The degree of postoperative diabetes insipidus had no relationship with classification of tumor and surgical approach(P>0.05), The type of electrolyte disturbance after surgery had no relationship with classification of tumor and surgical approach (P>0.05).Conclusions according the retrospective analysis of this group, the incidence of the diabetes insipidus and electrolyte disturbance, postoperative is significantly more frequent than preoperative in patients with craniopharyngioma. We found the factors related with the postoperative diabets insipidus and electrolyte disturbance were preoperative diabetes insipidus, intraoperative treatment of the pituitary stalk, tumor resection, tumor calcification. The degree of postoperative diabetes insipidus had no relationship with classification of tumor and surgical approach, The type of electrolyte disturbance after surgery had no relationship with classification of tumor and surgical approach. We should do preoperative evaluation in patients with craniopharyngioma, choose the proper approach, operate carefully and protect the hypothalamus and the pituitary stalk. the prevention and treatment of the postoperative complications is important for the treatment of craniopharyngioma.