Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors

Mahmoud Saad; Mohamed Elkahwagi; Ahmed Musaad; Yasser Khafagy; Ahmed Nageeb Taha

doi:doi:10.11648/j.ijn.20190302.13

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Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors

Mahmoud Saad, Mohamed Elkahwagi, Ahmed Musaad, Yasser Khafagy, Ahmed Nageeb Taha

Published in International Journal of Neurosurgery (Volume 3, Issue 2)

Received: 19 November 2019 Accepted: 2 December 2019 Published: 10 December 2019

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Abstract

Background: Cerebrospinal fluid (CSF) leak is a serious complication of endoscopic endonasal surgery for pituitary adenoma; leading to a more serious and financial burden of the surgery. Prediction of the occurrence of such sequale and proper plaining for reconstruction can reduce its prevalence and associated morbidities. Purpose: To determine the predictors and risk factors associated with intra/and postoperative cerebrospinal fluid (CSF) leaks in endoscopic endonasal pituitary surgery. Methods: A retrospective study included 150 patients who underwent endoscopic endonasal approach for resection of pituitary adenomas between 2015 and 2018. We analyzed the association between CSF leaks (intra/post-operative) and perioperative variables including patients’ demographic data, medical comorbidities, tumor characteristics and operative data (rates of intraoperative leak, reconstructive techniques). Results: 34 patients (22.6%) out of the 150 patients had an overall, CSF leak: 26 (76.5%) patients had intraoperative leaks; 5 patients out of them continued to have a postoperative leak. 8 patients (23.5%) had postoperative leak. Based on multiple logistic regression model analysis; increased body mass index (BMI), associated hydrocephalus, suprasellar extension and recurrent tumors had a significant association with intraoperative CSF leaks, while only BMI and hydrocephalus predicted postoperative CSF leaks. Conclusion: Elevated BMI, suprasellar extension of the tumor, recurrence or previous radiation are all important risk factors that have been proved in this study to have statistically significant association with the incidence of CSF leak. In high risk patients for CSF leakage: adequate reconstruction planis advised to avoid such morbidity.

Published in	International Journal of Neurosurgery (Volume 3, Issue 2)
DOI	10.11648/j.ijn.20190302.13
Page(s)	26-31
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

CSF, Leak, Endoscopic Endonasal, Pituitary Surgery, Predictors

References

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APA Style

Mahmoud Saad, Mohamed Elkahwagi, Ahmed Musaad, Yasser Khafagy, Ahmed Nageeb Taha. (2019). Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors. International Journal of Neurosurgery, 3(2), 26-31. https://doi.org/10.11648/j.ijn.20190302.13

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ACS Style

Mahmoud Saad; Mohamed Elkahwagi; Ahmed Musaad; Yasser Khafagy; Ahmed Nageeb Taha. Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors. Int. J. Neurosurg. 2019, 3(2), 26-31. doi: 10.11648/j.ijn.20190302.13

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AMA Style

Mahmoud Saad, Mohamed Elkahwagi, Ahmed Musaad, Yasser Khafagy, Ahmed Nageeb Taha. Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors. Int J Neurosurg. 2019;3(2):26-31. doi: 10.11648/j.ijn.20190302.13

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@article{10.11648/j.ijn.20190302.13,
  author = {Mahmoud Saad and Mohamed Elkahwagi and Ahmed Musaad and Yasser Khafagy and Ahmed Nageeb Taha},
  title = {Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors},
  journal = {International Journal of Neurosurgery},
  volume = {3},
  number = {2},
  pages = {26-31},
  doi = {10.11648/j.ijn.20190302.13},
  url = {https://doi.org/10.11648/j.ijn.20190302.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20190302.13},
  abstract = {Background: Cerebrospinal fluid (CSF) leak is a serious complication of endoscopic endonasal surgery for pituitary adenoma; leading to a more serious and financial burden of the surgery. Prediction of the occurrence of such sequale and proper plaining for reconstruction can reduce its prevalence and associated morbidities. Purpose: To determine the predictors and risk factors associated with intra/and postoperative cerebrospinal fluid (CSF) leaks in endoscopic endonasal pituitary surgery. Methods: A retrospective study included 150 patients who underwent endoscopic endonasal approach for resection of pituitary adenomas between 2015 and 2018. We analyzed the association between CSF leaks (intra/post-operative) and perioperative variables including patients’ demographic data, medical comorbidities, tumor characteristics and operative data (rates of intraoperative leak, reconstructive techniques). Results: 34 patients (22.6%) out of the 150 patients had an overall, CSF leak: 26 (76.5%) patients had intraoperative leaks; 5 patients out of them continued to have a postoperative leak. 8 patients (23.5%) had postoperative leak. Based on multiple logistic regression model analysis; increased body mass index (BMI), associated hydrocephalus, suprasellar extension and recurrent tumors had a significant association with intraoperative CSF leaks, while only BMI and hydrocephalus predicted postoperative CSF leaks. Conclusion: Elevated BMI, suprasellar extension of the tumor, recurrence or previous radiation are all important risk factors that have been proved in this study to have statistically significant association with the incidence of CSF leak. In high risk patients for CSF leakage: adequate reconstruction planis advised to avoid such morbidity.},
 year = {2019}
}

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TY  - JOUR
T1  - Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors
AU  - Mahmoud Saad
AU  - Mohamed Elkahwagi
AU  - Ahmed Musaad
AU  - Yasser Khafagy
AU  - Ahmed Nageeb Taha
Y1  - 2019/12/10
PY  - 2019
N1  - https://doi.org/10.11648/j.ijn.20190302.13
DO  - 10.11648/j.ijn.20190302.13
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 26
EP  - 31
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20190302.13
AB  - Background: Cerebrospinal fluid (CSF) leak is a serious complication of endoscopic endonasal surgery for pituitary adenoma; leading to a more serious and financial burden of the surgery. Prediction of the occurrence of such sequale and proper plaining for reconstruction can reduce its prevalence and associated morbidities. Purpose: To determine the predictors and risk factors associated with intra/and postoperative cerebrospinal fluid (CSF) leaks in endoscopic endonasal pituitary surgery. Methods: A retrospective study included 150 patients who underwent endoscopic endonasal approach for resection of pituitary adenomas between 2015 and 2018. We analyzed the association between CSF leaks (intra/post-operative) and perioperative variables including patients’ demographic data, medical comorbidities, tumor characteristics and operative data (rates of intraoperative leak, reconstructive techniques). Results: 34 patients (22.6%) out of the 150 patients had an overall, CSF leak: 26 (76.5%) patients had intraoperative leaks; 5 patients out of them continued to have a postoperative leak. 8 patients (23.5%) had postoperative leak. Based on multiple logistic regression model analysis; increased body mass index (BMI), associated hydrocephalus, suprasellar extension and recurrent tumors had a significant association with intraoperative CSF leaks, while only BMI and hydrocephalus predicted postoperative CSF leaks. Conclusion: Elevated BMI, suprasellar extension of the tumor, recurrence or previous radiation are all important risk factors that have been proved in this study to have statistically significant association with the incidence of CSF leak. In high risk patients for CSF leakage: adequate reconstruction planis advised to avoid such morbidity.
VL  - 3
IS  - 2
ER  -

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Author Information

Mahmoud Saad

Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Mohamed Elkahwagi

Department of Otolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Ahmed Musaad

Department of Otolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Yasser Khafagy

Department of Otolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Ahmed Nageeb Taha

Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

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APA Style

Mahmoud Saad, Mohamed Elkahwagi, Ahmed Musaad, Yasser Khafagy, Ahmed Nageeb Taha. (2019). Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors. International Journal of Neurosurgery, 3(2), 26-31. https://doi.org/10.11648/j.ijn.20190302.13

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ACS Style

Mahmoud Saad; Mohamed Elkahwagi; Ahmed Musaad; Yasser Khafagy; Ahmed Nageeb Taha. Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors. Int. J. Neurosurg. 2019, 3(2), 26-31. doi: 10.11648/j.ijn.20190302.13

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AMA Style

Mahmoud Saad, Mohamed Elkahwagi, Ahmed Musaad, Yasser Khafagy, Ahmed Nageeb Taha. Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors. Int J Neurosurg. 2019;3(2):26-31. doi: 10.11648/j.ijn.20190302.13

Copy | Download

@article{10.11648/j.ijn.20190302.13,
  author = {Mahmoud Saad and Mohamed Elkahwagi and Ahmed Musaad and Yasser Khafagy and Ahmed Nageeb Taha},
  title = {Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors},
  journal = {International Journal of Neurosurgery},
  volume = {3},
  number = {2},
  pages = {26-31},
  doi = {10.11648/j.ijn.20190302.13},
  url = {https://doi.org/10.11648/j.ijn.20190302.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20190302.13},
  abstract = {Background: Cerebrospinal fluid (CSF) leak is a serious complication of endoscopic endonasal surgery for pituitary adenoma; leading to a more serious and financial burden of the surgery. Prediction of the occurrence of such sequale and proper plaining for reconstruction can reduce its prevalence and associated morbidities. Purpose: To determine the predictors and risk factors associated with intra/and postoperative cerebrospinal fluid (CSF) leaks in endoscopic endonasal pituitary surgery. Methods: A retrospective study included 150 patients who underwent endoscopic endonasal approach for resection of pituitary adenomas between 2015 and 2018. We analyzed the association between CSF leaks (intra/post-operative) and perioperative variables including patients’ demographic data, medical comorbidities, tumor characteristics and operative data (rates of intraoperative leak, reconstructive techniques). Results: 34 patients (22.6%) out of the 150 patients had an overall, CSF leak: 26 (76.5%) patients had intraoperative leaks; 5 patients out of them continued to have a postoperative leak. 8 patients (23.5%) had postoperative leak. Based on multiple logistic regression model analysis; increased body mass index (BMI), associated hydrocephalus, suprasellar extension and recurrent tumors had a significant association with intraoperative CSF leaks, while only BMI and hydrocephalus predicted postoperative CSF leaks. Conclusion: Elevated BMI, suprasellar extension of the tumor, recurrence or previous radiation are all important risk factors that have been proved in this study to have statistically significant association with the incidence of CSF leak. In high risk patients for CSF leakage: adequate reconstruction planis advised to avoid such morbidity.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Predictors of Cerebrospinal Fluid Leaks in Endoscopic Surgery for Pituitary Tumors
AU  - Mahmoud Saad
AU  - Mohamed Elkahwagi
AU  - Ahmed Musaad
AU  - Yasser Khafagy
AU  - Ahmed Nageeb Taha
Y1  - 2019/12/10
PY  - 2019
N1  - https://doi.org/10.11648/j.ijn.20190302.13
DO  - 10.11648/j.ijn.20190302.13
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 26
EP  - 31
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20190302.13
AB  - Background: Cerebrospinal fluid (CSF) leak is a serious complication of endoscopic endonasal surgery for pituitary adenoma; leading to a more serious and financial burden of the surgery. Prediction of the occurrence of such sequale and proper plaining for reconstruction can reduce its prevalence and associated morbidities. Purpose: To determine the predictors and risk factors associated with intra/and postoperative cerebrospinal fluid (CSF) leaks in endoscopic endonasal pituitary surgery. Methods: A retrospective study included 150 patients who underwent endoscopic endonasal approach for resection of pituitary adenomas between 2015 and 2018. We analyzed the association between CSF leaks (intra/post-operative) and perioperative variables including patients’ demographic data, medical comorbidities, tumor characteristics and operative data (rates of intraoperative leak, reconstructive techniques). Results: 34 patients (22.6%) out of the 150 patients had an overall, CSF leak: 26 (76.5%) patients had intraoperative leaks; 5 patients out of them continued to have a postoperative leak. 8 patients (23.5%) had postoperative leak. Based on multiple logistic regression model analysis; increased body mass index (BMI), associated hydrocephalus, suprasellar extension and recurrent tumors had a significant association with intraoperative CSF leaks, while only BMI and hydrocephalus predicted postoperative CSF leaks. Conclusion: Elevated BMI, suprasellar extension of the tumor, recurrence or previous radiation are all important risk factors that have been proved in this study to have statistically significant association with the incidence of CSF leak. In high risk patients for CSF leakage: adequate reconstruction planis advised to avoid such morbidity.
VL  - 3
IS  - 2
ER  -

Copy | Download