Influencing Factors Of Diabetes Insipidus After Neuroendoscopic Transsphenoidal Surgery On Patients With Nonfunction Pituitary Adenomas

Purpose To explore the influencing factors of diabetes insipidus after neuroendoscopic transsphenoidal surgery for nonfunctional pituitary adenoma.Method A retrospective analysis was conducted on 96 cases of neuroendoscopic transsphenoidal surgery for nonfunctional pituitary adenoma between December 2015 to December 2018 at Neurosurgery Department at Shenzhen Second People’s Hospital.The influencing factors that may lead to postoperative diabetes insipidus were analyzed by univariate and multivariate logistic regression analysis.(There is statistical significance when P<0.05).Result There are 30 cases of postoperative diabetes insipidus in the 96 patients who underwent neuroendoscopic transsphenoidal surgery for nonfunctional pituitary adenoma.The incidence of postoperative diabetes insipidus was 31.2%.Tumor resection rate and tumor breakthrough through sellar septum may be risk factors for postoperative diabetes insipidus.The statistical analysis indicated that tumor diameter is an independent risk factor for postoperative diabetes insipidus.(P = 0.011,OR = 5.315,95% CI = 1.460-19.347),and pituitary macroadenoma is more likely to cause postoperative diabetes insipidus than pituitary macroadenoma.Pituitary apoplexy is an independent risk factor for postoperative diabetes insipidus(P = 0.038,OR = 4.003,95% CI = 1.082-14.809).Patients with tumor stroke are more likely to cause postoperative diabetes insipidus.Conclusion Tumor diameter and pituitary apoplexy are independent risk factors for postoperative diabetes insipidus.Giant pituitary adenomas are more likely to cause postoperative diabetes insipidus than giant pituitary adenomas,and pituitary apoplexy is more prone to postoperative diabetes insipidus.The low rate of diabetes insipidus in this present series depends on two factors: adequate preoperative imaging examination and neurosurgeon’s gentle operation during the operation.Postoperative management should be strengthened for patients with giant pituitary adenoma and pituitary apoplexy.