Impact of nasal septal deviation on surgical outcomes in endoscopic transsphenoidal surgery: a population-based study.

IF 3.3 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Chia-En Wong, Da-Wei Huang, Yu Chang, Heng-Jui Hsu, Liang-Chao Wang, Po-Hsuan Lee, Hao-Hsiang Hsu, Pang-Shuo Perng, Chih-Hao Tien, Jung-Shun Lee
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Abstract

Purpose: Nasal septal deviation (NSD) is a prevalent condition that may affect the surgical outcome of endoscopic transsphenoidal approach surgery (ETA) for pituitary adenomas (PA). This study aims to evaluate the effect of NSD on perioperative and neuroendocrine outcomes in patients undergoing ETA for PAs.

Methods: This study is a retrospective analysis utilized the TriNetX database to evaluate the effect of NSD on perioperative and neuroendocrine outcomes in patients undergoing ETA for PAs. Propensity score matching (PSM) was performed to balance baseline characteristics between NSD and non-NSD cohorts. Outcomes were presented as odds ratios (ORs) with 95% confidence intervals (CIs), calculated using the TriNetX platform. Primary outcomes include perioperative complications and postoperative endocrinological functions.

Results: A total of 9,896 patients were included in the initial cohort. After matching, 2,002 patients were included in each group. The mean age at surgery was 53.1 ± 15.8 years for the NSD group and 53.0 ± 16.0 years for the non-NSD groups (SMD: 0.006, p = 0.842). Patients in the NSD group demonstrated a higher risk of postoperative cerebrospinal fluid (CSF) leakage (OR: 2.04; 95% CI: 1.63-2.54; p < 0.001), postoperative diabetes insipidus (DI) (OR: 1.36; 95% CI: 1.18-1.57; p < 0.001), desmopressin use (OR: 1.26; 95% CI: 1.06-1.51; p = 0.009), hypopituitarism (OR:1.63; 95% CI: 1.40-1.89; p < 0.001), and steroid use (OR: 1.43; 95% CI: 1.25-1.62; p < 0.001) as compared to the non-NSD group. Sensitivity analyses confirmed consistent results across different matching models.

Conclusions: These findings indicate that patients with NSD undertaking ETA for PAs had higher risks of postoperative complications, including postoperative CSF leakage, DI, desmopressin use, hypopituitarism, and steroid use.

鼻中隔偏曲对内镜下蝶窦手术结果的影响:一项基于人群的研究。
目的:鼻中隔偏曲(NSD)是一种常见的疾病,可能影响经蝶窦内镜入路手术(ETA)治疗垂体腺瘤(PA)的手术效果。本研究旨在评估NSD对PAs行ETA患者围手术期和神经内分泌预后的影响。方法:本研究利用TriNetX数据库进行回顾性分析,评估NSD对PAs行ETA患者围手术期和神经内分泌预后的影响。采用倾向评分匹配(PSM)来平衡NSD和非NSD队列之间的基线特征。结果以比值比(or)和95%置信区间(ci)表示,使用TriNetX平台计算。主要结局包括围手术期并发症和术后内分泌功能。结果:初始队列共纳入9896例患者。配对后,每组纳入2002例患者。手术时平均年龄NSD组为53.1±15.8岁,非NSD组为53.0±16.0岁(SMD: 0.006, p = 0.842)。NSD组患者术后脑脊液(CSF)渗漏的风险较高(OR: 2.04;95% ci: 1.63-2.54;结论:这些发现表明,接受ETA治疗PAs的NSD患者有更高的术后并发症风险,包括术后脑脊液漏、DI、去氨加压素使用、垂体功能低下和类固醇使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pituitary
Pituitary 医学-内分泌学与代谢
CiteScore
7.10
自引率
7.90%
发文量
90
审稿时长
6 months
期刊介绍: Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.
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