与星外肿瘤术后脑脊液漏有关的风险因素

IF 0.3 Q4 EDUCATION & EDUCATIONAL RESEARCH Teaching Theology and Religion Pub Date : 2023-01-16 eCollection Date: 2024-02-01 DOI:10.1055/s-0042-1760355
Huan Zhang, Sophie Peeters, Gennadiy Vengorivich, Layal Antoury, Ki Wan Park, Christine Wells, Jeffrey D Suh, Jivianne T Lee, Anthony Heaney, Marvin Bergsneider, Won Kim, Marilene B Wang
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摘要

目的 虽然垂体瘤术后脑脊液(CSF)漏率的研究较多,但针对星外肿瘤术后 CSF 漏率的研究较少。本研究旨在确定接受内窥镜手术治疗星外肿瘤的患者术后发生 CSF 泄漏的风险因素。方法 对 2008 年至 2020 年期间接受内镜手术切除杏仁外肿瘤的患者进行回顾性病历审查。确定了年龄、性别、肿瘤类型、肿瘤位置、肿瘤大小、重建技术、合并症和其他潜在风险因素。对数据进行分析,以确定导致术后 CSF 渗漏的重要风险因素。结果 有100名外胚叶肿瘤患者在术中出现脑脊液漏。17名患者(17%)出现术后CSF漏。漏液发生的时间中位数为术后 2 天(范围为 0-34 天)。瓣膜肿瘤术后漏液的发生率明显高于其他部位的肿瘤(P = 0.12)。结论 与垂体瘤相比,星外肿瘤(尤其是蝶鞍肿瘤)术后 CSF 渗漏的发生率更高。对于术后出现 CSF 漏的高危患者,可考虑预防性腰椎引流。
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Risk Factors Associated with Postoperative CSF Leak in Extrasellar Tumors.

Objective  While postoperative cerebrospinal fluid (CSF) leak rates of pituitary tumors have been frequently studied, there are fewer studies examining postoperative CSF leak rates for extrasellar tumors. The purpose of this study was to identify risk factors for the development of postoperative CSF leak in patients undergoing endoscopic surgery for extrasellar tumors. Methods  A retrospective chart review was done for patients who underwent endoscopic resection for extrasellar tumors between 2008 and 2020. Age, gender, tumor type, tumor location, tumor size, reconstruction technique, medical comorbidities, and other potential risk factors were identified. Data was analyzed to identify significant risk factors for development of postoperative CSF leak. Results  There were 100 patients with extrasellar tumors who developed intraoperative CSF leaks. Seventeen patients (17%) developed postoperative CSF leaks. Leaks occurred at a median of 2 days following surgery (range 0-34 days). Clival tumors had a significantly higher incidence of postoperative leak than those in other sites ( p  < 0.05). There were no significant differences in other locations, body mass index, tumor size, reconstruction technique, medical comorbidities, or other factors. There were nearly twice as many intraoperative grade III leaks in those who developed postoperative CSF leak, but this was not statistically significant ( p  = 0.12). Conclusion  Extrasellar tumors, particularly clival tumors, have a higher rate of postoperative CSF leak than pituitary tumors. Prophylactic lumbar drains can be considered for patients at high risk for developing postoperative CSF leak.

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