The Prevention And Management Of Postoperative Complications In Pediatric Craniopharyngioma

Objective: To explore the characteristics,prevention and management of postoperative complications in pediatric craniopharyngioma.Methods: The clinical data of 26 children who were 14 years old or less,underwent neurosurgery for craniopharyngioma in the recent years were retrospectively analyzed.The prevention and management of these complications in children were explored.Results: Eight cases underwent total tumor removal,11 with subtotal removal and 7 with partial removal. No one died from them.The complications included: Diabetes insipidus in 23 cases (88.5%), after administration of vasopressin , most of patients the urine output returned to normal, after six months; electrolyte disorder in 20 cases (76.9%), which initially hypernatremia then hyponatremia in 6 cases (23.1%), simple hyponatremia in 12 patients (46.2%) (including low dilution hypernatremia in 2 patients after 1 week), simple hypernatremia in 2 cases (7.7%), through close monitoring of electrolytes and provided symptomatic treatment were normal; pituitary dysfunction occurred in 14 cases (53.8%), for cortisol hormone replacement therapy,with varying degree improvement of the endocrine function,including one baby who was 3-month-old,the level of ACTH and TSH assays improved.Bilateral frontal subdural effusion in 13 cases (50%), the reasionable position (taking Trendelenburg:the head of the bed was down,the foot of bed elevated)and the use of external drainage of subdural effusion were cured in six months; high fever in 11 cases (42.3%) treated by physical cooling, body temperature were gradually returning to normal; epileptic seizures in 8 cases (30.8%), by antiepileptic drugs,seizures were controlled; of impaired consciousness in 6 cases (23.1%), mainly as clouding of consciousness and lethargy, after symptomatic treatment the consciousness returned to normal; 4 cases of abnormal vital signs(All babies under 3 years old),by close monitoring of vital signs, just right for the illness treatment of the patients were restored steadily in 48h; hemiplegia in 2 cases (7.7%),there were varying degree improvement using antivasospasmic drugs,hyperdynamic therapy and hypervolemic hemodilution; gastrointestinal bleeding in 1 case (3.8%) to H2 receptor antagonists and antacids back to normal after treatment.Conclusion: A correct understanding of the postoperative complications in pediatric craniopharyngioma, prevention and treatment in time, is essential for improving the prognosis of patients.