ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
Polyuria and diabetes insipidus after surgery for pituitary tumors
Nerea Egaña Zunzunegui , Ismene Bilbao Garay , Cristina García Delgado , Izaskun Olaizola Iregui , Maite Perez de Ciriza Cordeu , Maria Luisa Antuñano Lopez , Maite Aramburu Calafell , Nicolas Sampron , Alfredo Yoldi Arrieta & Miguel Maria Goena Iglesias
Hospital Universitario Donostia, San Sebastian, Guipuzcoa, Spain.
Introduction: Central diabetes insipidus (DI) is a common complication after pituitary surgery, but is transient in the majority of patients. The aim of our study is to determine the incidence and course of DI in the postoperative period and to characterize the factors associated with this disease.
Methods: We performed a retrospective study of 44 patients (50% females) with a mean age of 54 years (24–83), treated with transsphenoidal (TSS) or transfrontal surgery (TFS) between January 2013 and December 2016. 26 were nonfuntioning adenoma, 7 somatotrophinoma, 6 corticotrophinoma, 2 gonadotrophinoma, 1 tirotrophinoma, 1 Rathke’s cyst and 1 craniopharyngeoma. 93.2% underwent TSS (72% endoscopic) and 6.8% (3 patients) TSF. 18% were reinterventions. We consider polyuria if diuresis is >200ml/h for 3 consecutive hours and DI if the natremia is >145 mEq/l so that the patient is candidate for subcutaneous desmopresine.
Results: 25 patients (56%) developed polyuria during early postoperative, 11 (25%) transient DI between 1 and 5th day and 10 (22%) SiADH between 3 and 10th day. 15% of these patients presented 2 phases Di+SiADH, none of them 3 phases. DI was permanent in only 3 patients (6.8%), all after TFS. There was no difference comparing the DI group vs no DI in tumor size, pituitary function and surgery technique. However, we found differences between transient and permanent DI groups in tumor size (53×36×42 vs 18×16×15 P<0.05) and surgery technique (TFS vs TSS P<0.05), but not in age, pituitary function or number of interventions.
Conclusion: It is important to identify those patients in risk of developing permanent DI, which in our case were those with bigger tumors that required TFS.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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