Abstract
ObjectiveTo analyse the risk factors for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection (NTPAR) to provide a reference for the prevention and treatment of postoperative intracranial infection.MethodsThe clinical data of 387 patients who underwent NTPAR in the Department of Neurosurgery of the First People’s Hospital of Yichang from March 2013 to March 2021 were retrospectively analysed. The patients were divided into an infected group and a noninfected group according to the occurrence of intracranial infection. The detailed clinical data of the two groups were collected. Univariate and multivariate logistic regression was used to analyse the risk factors for intracranial infection after NTPAR.ResultsAmong the 387 surgical patients, 32 patients (8.27%) were in the intracranially infected group and 355 patients (91.73%) were in the noninfected group. The results of the univariate analysis suggested that age > 45 years, tumour size > 1 cm, operation time > 240 min, blood loss > 400 ml, Kelly Grade of cerebrospinal fluid (CSF) leakage > Grade 2, postoperative CSF leakage, lumbar cistern drainage and blood transfusion were the influencing factors for postoperative intracranial infection, while the results of multivariate logistic regression analysis implied that intraoperative CSF leakage (Kelly Grade > 2) and postoperative CSF leakage were independent influencing factors for intracranial infection after NTPAR, and perioperative use of antibiotics was an independent protective factor for postoperative intracranial infection.ConclusionsThere are a variety of risk factors for intracranial infection after NTPAR, which indicates that it is necessary to develop different repair strategies for CSF leakage according to the Kelly Grade, timely treatment of postoperative CSF leakage and perioperative use of antibiotics. These measures have been shown to effectively reduce the probability of intracranial infection after NTPAR.
Highlights
Pituitary adenomas are common benign tumours of the nervous system, second only to gliomas and meningiomas, accounting for approximately 15% of intracranial tumours [1]
Between‐group comparisons of general clinical data A total of 387 patients with pituitary adenomas were enrolled in this study, all of whom underwent neuroendoscopic transnasal pituitary adenoma resection (NTPAR)
Perioperative use of antibiotics was a protective factor against postoperative intracranial infection
Summary
Pituitary adenomas are common benign tumours of the nervous system, second only to gliomas and meningiomas, accounting for approximately 15% of intracranial tumours [1]. With the exception of prolactinomas, pituitary adenomas usually require surgical treatment [2]. Huang et al BMC Neuroscience (2022) 23:1 endoscopic technology, neuroendoscopic transnasal pituitary adenoma resection (NTPAR) has become the standard surgical method [3]. Endoscopic transnasal surgery has the advantages of less trauma, a clear field of vision and a low incidence of complications, some patients still have complications, such as postoperative cerebrospinal fluid (CSF) leakage, intracranial infection, intracranial haemorrhage, permanent diabetes insipidus, and optic nerve injury [4]. Bacteria can enter the brain through surgical instruments or CSF to cause intracranial infection. The transnasal approach has a high potential risk of intracranial infection, with an incidence of 3.59% [5]. There are few studies on the risk factors for and prevention of intracranial infection after NTPAR either at home or abroad. The related risk factors for intracranial infection after NTPAR were analysed, and the independent risk factors for intracranial infection were determined to provide relevant intracranial infection prevention strategies
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