Analysis Of Hormonal Variation In Pre And Post-operative Craniopharyngioma Patients, Some Special Experience

Objective The purpose of this thesis is to retrospectively review our experience of the hormonal variation seen in pre and post-operative craniopharyngioma patients. We also aim to observe the mean age, gender ratio and frequency of hypothyroidism and other hormonal pattern in our patients.Materials and Methods A retrospective study of34adult patients who were surgically treated in Huanhu hospital from2008to2013. Inclusion criteria for the study were as follow:age>18years, all the patient underwent total tumour resection surgery, all the patient were subjected to minimised frontal lateral approach and operated by single surgeon and his team. The lab results of the individual hormone done at different time interval were studied and only two reading, one in pre-operative period at the time of admission and the other at7th to10th post-operative period were taken into consideration for the study. Both the reading was compared to establish pattern of change seen in the study group. The data were statistically analysed using the Statistical Package for the Social Science (SPSS version17.0). Statistical significance was assessed using the non-parametric two-dependent samples test (Wilcoxon signed rank test). The Data were statistically significant at P<0.05.Results A total of34patients meeting all the inclusion criteria for study were studied.1. The mean age with standard deviation of the patients included in this study was (47.11±1.2) years and median age was50.2. The ratio of female to male in our study was1:1.3.3. No tumor residue was seen in MRI done1month after the surgery and no death occurred during that time period.4. Out of the34patients with total tumor removal,5(14.7%) had tumor recurrence within an average of2.6years.5. The pre-operative and post-operative hormonal status of the thyroid hormone was as follows:mean plasma level of pre-operative T3, T4, TSH were2.41nmol/L,48.99nmol/L,2.05uIU/ml and post-operative values for T3, T4, TSH were1.73nmol/L,23.47nmol/Land0.16uIU/ml respectively.6. The hormonal status of other anterior pituitary hormone were as follows: mean plasma level pre and post-operatively values of LH was3.35mIU/ml and1.78mIU/ml, PRL was24.04ng/ml and18.59ng/ml, GRH was0.372ng/ml and0.34ng/ml, COR was15.81ug/dl and8.30ug/ml, FSH was8.94mIU/L and4.87mIU/L respectively.7. A significant difference in the mean of pre and post-operative hormonal value in T3, T4, TSH, GRH, FSH, LH and no significant difference in the mean of PRL was observed in this study.Conclusions1. In this study, we have analyzed the rates of endocrinal complications and hormonal variation in the craniopharyngioma patients. We were able to demonstrate the changes in individual pituitary hormonal with regards to treatment intervention.2. Our study supports the fact that hormonal variation in pre and postoperative group is significant. Our study also showed lesser degree of postoperative hormonal deficient in comparison to other published literature. This study can serve as an estimate of expected outcomes for these patients, and guide decision making and facilitate further researches in this field.