Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery
IntroductionWater and electrolyte disturbances are common after pituitary surgery and can generally be classified into transient hypotonic polyuria and transient or permanent diabetes insipidus (DI). The prevalence varies in the literature between 31-51% for transient hypotonic polyuria, 5.1-25.2% f...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.963707/full |
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| author | Juan Manuel Canelo Moreno Elena Dios Fuentes Eva Venegas Moreno Pablo Jesús Remón Ruíz Cristina Muñoz Gómez Ana Piñar Gutiérrez Eugenio Cárdenas Valdepeñas Ariel Kaen Alfonso Soto Moreno |
| author_facet | Juan Manuel Canelo Moreno Elena Dios Fuentes Eva Venegas Moreno Pablo Jesús Remón Ruíz Cristina Muñoz Gómez Ana Piñar Gutiérrez Eugenio Cárdenas Valdepeñas Ariel Kaen Alfonso Soto Moreno |
| author_sort | Juan Manuel Canelo Moreno |
| collection | DOAJ |
| description | IntroductionWater and electrolyte disturbances are common after pituitary surgery and can generally be classified into transient hypotonic polyuria and transient or permanent diabetes insipidus (DI). The prevalence varies in the literature between 31-51% for transient hypotonic polyuria, 5.1-25.2% for transient DI, and 1-8.8% for permanent DI.ObjectiveThe aim of this study was to identify the prevalence of water and electrolyte disturbances with polyuria and the preoperative and postoperative predictive factors in patients undergoing surgery with an extended endoscopic endonasal approach.Material and methodsThis retrospective observational descriptive study included 203 patients with a diagnosis of pituitary adenoma who underwent their first transsphenoidal surgery via the extended endoscopic endonasal approach between April 2013 and February 2020. The diagnosis of water and electrolyte disturbances was based on the criterion for polyuria (>4 ml/kg/h). Postoperative polyuria was defined as those cases diagnosed during the immediate postsurgical period that resolved prior to discharge. Transient DI included all cases with a duration of less than 6 months but still present at hospital discharge, and permanent DI included cases lasting more than 6 months.ResultsThe overall prevalence of water and electrolyte disorders was 30.5% (62), and the prevalence of postoperative polyuria was 23.6% (48). The median number of desmopressin doses administered to patients with postoperative polyuria was one dose (interquartile range [IQR] 1-2), and thus the median duration of treatment was 0 days. The median initiation of desmopressin was the second day after surgery (IQR 1-2). The overall prevalence of DI was 6.89%. Among the patients with transient DI, the duration was less than 3 months in three patients (1.47%), and between 3 and 6 months in two (0.98%). Nine patients had permanent DI (4.43%). (4.43%).ConclusionsThe prevalence of electrolyte disturbances in our study was high, although similar to that found in the literature. Most of the cases were transient hypotonic polyuria that resolved within one day. The prevalence of transient DI in our cohort was lower than that described in the literature, while permanent DI was similar. |
| first_indexed | 2024-12-10T18:42:36Z |
| format | Article |
| id | doaj.art-f6ea6fec7f9941758353edf6a3507b26 |
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| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-10T18:42:36Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-f6ea6fec7f9941758353edf6a3507b262022-12-22T01:37:37ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.963707963707Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgeryJuan Manuel Canelo Moreno0Elena Dios Fuentes1Eva Venegas Moreno2Pablo Jesús Remón Ruíz3Cristina Muñoz Gómez4Ana Piñar Gutiérrez5Eugenio Cárdenas Valdepeñas6Ariel Kaen7Alfonso Soto Moreno8Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainUnidad de Gestión Clínica de Neurocirugía, Virgen del Rocío University Hospital, Seville, SpainUnidad de Gestión Clínica de Neurocirugía, Virgen del Rocío University Hospital, Seville, SpainUnidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Virgen del Rocio University Hospital, Centro Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, SpainIntroductionWater and electrolyte disturbances are common after pituitary surgery and can generally be classified into transient hypotonic polyuria and transient or permanent diabetes insipidus (DI). The prevalence varies in the literature between 31-51% for transient hypotonic polyuria, 5.1-25.2% for transient DI, and 1-8.8% for permanent DI.ObjectiveThe aim of this study was to identify the prevalence of water and electrolyte disturbances with polyuria and the preoperative and postoperative predictive factors in patients undergoing surgery with an extended endoscopic endonasal approach.Material and methodsThis retrospective observational descriptive study included 203 patients with a diagnosis of pituitary adenoma who underwent their first transsphenoidal surgery via the extended endoscopic endonasal approach between April 2013 and February 2020. The diagnosis of water and electrolyte disturbances was based on the criterion for polyuria (>4 ml/kg/h). Postoperative polyuria was defined as those cases diagnosed during the immediate postsurgical period that resolved prior to discharge. Transient DI included all cases with a duration of less than 6 months but still present at hospital discharge, and permanent DI included cases lasting more than 6 months.ResultsThe overall prevalence of water and electrolyte disorders was 30.5% (62), and the prevalence of postoperative polyuria was 23.6% (48). The median number of desmopressin doses administered to patients with postoperative polyuria was one dose (interquartile range [IQR] 1-2), and thus the median duration of treatment was 0 days. The median initiation of desmopressin was the second day after surgery (IQR 1-2). The overall prevalence of DI was 6.89%. Among the patients with transient DI, the duration was less than 3 months in three patients (1.47%), and between 3 and 6 months in two (0.98%). Nine patients had permanent DI (4.43%). (4.43%).ConclusionsThe prevalence of electrolyte disturbances in our study was high, although similar to that found in the literature. Most of the cases were transient hypotonic polyuria that resolved within one day. The prevalence of transient DI in our cohort was lower than that described in the literature, while permanent DI was similar.https://www.frontiersin.org/articles/10.3389/fendo.2022.963707/fullpituitary adenomatranssphenoidal surgeryextended endoscopic endonasal approachpolyuriadiabetes insipidus |
| spellingShingle | Juan Manuel Canelo Moreno Elena Dios Fuentes Eva Venegas Moreno Pablo Jesús Remón Ruíz Cristina Muñoz Gómez Ana Piñar Gutiérrez Eugenio Cárdenas Valdepeñas Ariel Kaen Alfonso Soto Moreno Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery Frontiers in Endocrinology pituitary adenoma transsphenoidal surgery extended endoscopic endonasal approach polyuria diabetes insipidus |
| title | Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery |
| title_full | Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery |
| title_fullStr | Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery |
| title_full_unstemmed | Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery |
| title_short | Postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery |
| title_sort | postoperative water and electrolyte disturbances after extended endoscopic endonasal transsphenoidal surgery |
| topic | pituitary adenoma transsphenoidal surgery extended endoscopic endonasal approach polyuria diabetes insipidus |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.963707/full |
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