Research ArticleOriginal Article
Open Access

Perioperative lumbar drain utilization in transsphenoidal pituitary resection

Shatha Alharbi, Griffith Harsh and Abdulrazag Ajlan
Neurosciences Journal January 2018, 23 (1) 46-51; DOI: https://doi.org/10.17712/nsj.2018.1.20170136

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Tables

  • Table 1

    Group comparison between groups 1 and 2.

    CharacteristicsGroup 1Group 2P-value
    Number of patients51135NA
    Postoperative CSF Leak1 (1.9)7 (5)0.3*
    Complications7 (13.7%)21 (15.5)0.72
    LHS (mean±SD)4.7±1.9 years2.7±2.4 years<0.001
    Functional7 (19)62 (45.9)<0.001*

    • ↵* Fisher exact test due to chi square assumption violation, CSF - cerebrospinal fluid, LHS - Length of hospital stay

  • Table 2

    Histopathology characteristics of our patients.

    Histopathologyn(%)
    Non-staining adenoma41(23.5)
    Prolactin-producing adenoma26(14.9)
    FSH-producing adenoma21(12)
    LH-producing adenoma1(.5)
    GH-producing adenoma19(10.9)
    ACTH-producing adenoma21(12)
    GH-, prolactin-producing adenoma6(3.4)
    FSH-, LH-producing adenoma12(6.8)
    Alpha-hCG-producing adenoma3(1.7)
    ACTH-, LH-producing adenoma1(.5)
    FSH-, alpha-hCG-producing adenoma7(4)
    Alpha-hCG-, FSH-, LH-producing adenoma7(4)
    TSH-, alpha-hCG-, prolactin-producing adenoma1(.5)
    TSH-, alpha-hCG-, GH-producing adenoma1(.5)
    FSH-, LH-, Atypical WHO II-producing adenoma1(.5)
    Not specified adenoma2(1.1)
    ACTH-, FSH-, GH-, prolactin-producing adenoma1(.5)
    TSH-producing adenoma1(.5)
    Spindle cell oncocytoma1(.5)
    Corticotroph cell hyperplasia1(.5)

    • TSH - Thyroid Stimulating Hormone, LH - Luteinizing Hormone, HCG - Human chorionic gonadotropin, FSH - Follicle Stimulating Hormone, ACTH - Adrenocorticotrophic hormone, GH - growth hormone

  • Table 3

    Management of patients with postoperative cerebrospinal fluid leak.

    PatientsTreatment
    1Conservatively, by lumbar drain
    2Conservatively, by lumbar drain
    3Conservatively, by lumbar drain
    4Surgical repair
    5Conservatively, by lumbar drain
    6Surgical repair
    7Conservatively, by lumbar drain
    8Conservatively, by lumbar drain
  • Table 4

    Reasons for extending hospital stay (comparison between 2 groups).

    ReasonsGroup 1Group 2
    n (%)
    CSF leak1 (1.9)7 (5)
    Nasal bleeding1 (1.9)1 (0.74)
    BradycardiaNone1 (0.74)
    Hemodynamic instabilityNone1 (0.74)
    Electrolyte abnormalitiesNone2 (1.4)
    Headache2 (3.9)None
    Deep venous thrombosisNone2 (1.4)
    Wound infection*1 (1.9)None
    SinusitisNone1 (0.74)
    Intracranial bleedingNone1 (0.74)
    Pulmonary embolismNone1 (0.74)
    Urinary tract infectionNone1 (0.74)
    Subdural hematomaNone1 (0.74)
    Visual loss†1 (1.9)1 (0.74)‡
    Hematuria§None1 (0.74)
    Cardiac arrestNone1 (0.74)
    Diabetes insipidusNone10 (7.4)
    Thyroid stormNone1 (0.74)

    • ↵* Wound infection at abdominal fat graft site,

    • ↵† Due to overpacking during surgical repair, this patient required reoperation,

    • ↵‡ An ophthalmic artery aneurysm was detected and surgically treated,

    • ↵§ Related to Foley catheter, CSF - Cerebrospinal fluid

  • Table 5

    Histopathologic subtype and other variables in group 2 patient with postoperative CSF leak.

    PatientSexHistopathologyFunctional
    1FAdenoma, alpha subunitNo
    2FAdenoma, FSH, alpha-hCGNo
    3FAdenoma, ACTHNo
    4MAdenoma, non-stainingNo
    5FAdenoma, ACTH, FSH, GH, prolactinNo
    6FAdenoma, FSHNo
    7FAdenoma, non-stainingNo

    • TSH - Thyroid Stimulating Hormone, LH - Luteinizing Hormone, HCG - Human chorionic gonadotropin, FSH - Follicle Stimulating Hormone, ACTH - Adrenocorticotrophic hormone, GH - growth hormone

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