Clinical Analysis Of The Complications Following Craniopharyngioma Resection

Objective:To investigate the clinical characteristics of craniopharyngioma and the factors that affect postoperative complications.Methods:Retrospectively,we analyzed the clinical data of 86 craniopharyngioma patients treated in Qilu Hospital from April 2005 to December 2008,all the patients had surgical treatment.Univariate ana lysis was performed using the chi-square test.Gender,age,primary,r ecur,preoperative diabetes insipidus,endocrine symptom,extent of re section,postoperative diabetes insipidus were assessed to investigat e the related prognostic factors.Results:This group included 86 patients.52(60%) were male,34(40) were female.The range of the patient's age was 5-65;the average age was 37±17.There were 16 teenagers(19%) and 70 adults(81%).66 craniopharyngioma patients(77%) were primary and 20 patients(23%) were recrudescent. In this group,50 patients(58%) had headache;16 vomited;78 (91) had vision decline;38(44%) had visual field defect;10 had ablepsia. 8 male patients had sexual functions decrease or sexual dysfunction. 12 female patients had menstruation irregularis or amenorrhea.Before the operation,26 patients had diabetes insipidus and 23 patient's PRL level was high.All the patients had surgical treatment.67 patients (78%) had total resections and 19 patients(22%) had subtotal r esections.Using the statistical analysis,we found that the incidence of the postoperative diabetes insipidus and electrolyte disturbances were high,the incidence were 80%and 70%.The incidence had no relat- ionship with age,primary and recur.The incidence of the postoperative diabetes insipidus had relationship with gender,preoperative diabetes insipidus,endocrine symptom and extent of resection(P＜0.05). The incidence of the natremia disturbances had relationship with preoperative diabetes insipidus,extent of resection,postoperative diabetes insipidus(P＜0.05).The hypokalemia was closely related with the postoperative diabetes insipidus.Conclusions:According the retrospective analysis,we found the factors related with the diabetes insipidus were gender,preoperative diabetes insipidus,endocrine symptom and extent of resection and the factors related with the natremia disturbances were preoperative diabetes insipidus,extent of resection and postoperative diabetes insipidus. The hypokalemia was closely related with the postoperative dia betes insipidus.So we should do preoperative evaluation,choose the proper approach,operate carefully and protect the hypothalamus and the pituitary stalk to decrease the incidence of the complication.