ECE2023 Eposter Presentations Pituitary and Neuroendocrinology (234 abstracts)
Metabolic and surgical outcomes of adult patients with craniopharyngiomapatients undergoing extended transsphenoidal surgery (ETS) at a referral center
Ana Piñar Gutiérrez 1 , Elena Dios 1 , Eva Venegas-Moreno 1 , Pablo Remon 1 , Bothayna Oulad Ahmed 1 , Ariel Kaen 1 , Eugenio Cárdenas 1 , Elena Fajardo 1 , David Cano Gonzales 1 & Alfonso Soto-Moreno 1
Virgen del Rocío University Hospital, Sevilla, Spain
Objectives: To describe the metabolic and surgical outcomes of adult patients with craniopharyngioma undergoing extended transsphenoidal surgery (ETS). Secondary: to compare surgical outcomes with patients undergoing conventional transcranial surgery (CTS).
Methods: Retrospective observational study. Adult patients with craniopharyngiomas undergoing ETS between 2015 and 2020 were included. Descriptive analysis was performed by obtaining median and quartiles for quantitative variables and frequency for qualitative variables. For the comparison between groups, a matched cohort of patients with craniopharyngioma who underwent CTS was used and a Fisher test was performed for qualitative variables.
Results: n=16. Male=7(43.8%); age=52.5(37.7–66) years. Follow-up time=44.5(30–63) months. BMI pre-surgery=26.01(22.72–28.51)kg/m2. The BMI increase at first year after surgery was 18.14%(7.2–24.26%). Obesity was present in 56.5% at first year post-surgery, although 77.7% were grade I (WHO classification). During follow-up, 25% developed type 2 diabetes and dyslipidaemia.
| First month post-ETS (n=16) | First year post-ETS (n=14) | |
| Complications after surgery | 15(93.8%) | 13(92.8%) |
| Diabetes insipidus | 15(93.8%) | 12(85.7%) |
| Adipsia | 0(0%) | 1(7.1%) |
| Panhypopituitarism | 14(87.5%) | 11(78.5%) |
| Hypothyroidism | 15(93.8%) | 13(92.8%) |
| Adrenal insufficiency | 17(87.5%) | 12(85.7%) |
| Hydrocephalus | 11(32.4%) | 1(7.1%) |
| Seizures/anti-epileptic treatment | 1(6.3%) | 1(7.1%) |
| Cerebrospinal fluid fistula | 1(6.3%) | 0(0%) |
| Central nervous system infection | 3(18.8%) | 0(0%) |
| Visual disturbances | 9(56.3%) | 7(50%) |
| Psychiatric disorders | 1(6.3%) | 1(7.1%) |
| Neurological disorders | 3(18.8%) | 4(28.5%) |
| ETS | CTS | P | ||
| At first month | Adipsia | 0(0%) | 7(20.6%) | 0.05 |
| Seizures | 1(6.3%) | 11(32.4%) | 0.03 | |
| Psychiatric disorders | 1(6.3%) | 12(35.3%) | 0.021 | |
| Neurological disorders | 3(18.8%) | 7(50%) | 0.023 | |
| At first year | Anti-epileptic treatment | 1(7.1%) | 11(39.2%) | 0.03 |
| Psychiatric disorders | 1(7.1%) | 12(42.8%) | 0.018 | |
| Hydrocephalus | 1(7.1%) | 9(32.1%) | 0.075 |
Conclusions The most frequent metabolic complication after ETS in patients presenting with craniopharyngioma was obesity, present in 56% of patients in our study. Surgical complications were very frequent (93.8% and 92.8% one month and one year after surgery) due to the high rate of diabetes insipidus (98.8% and 85.7%) and hypopituitarism (87.5% and 78.5%). These data are consistent with the scientific literature and lower than with CTS. ETS compared to CTS reduces adipsia, seizures and psychiatric and surgical complications at first month and hydrocephalus, need for antiepileptic treatment and psychiatric complications at first year after surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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