Hypopituitarism, Diabetes Insipidus, and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Pituitary Macroadenoma Surgery with Indocyanine Green Dye
Abstract
:1. Introduction
2. Materials and Methods
- Patients
- Indocyanine green material
- Optics
- Hormonal testing
- Radiologic evaluation
- Statistical analysis of the data
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All n = 34 | ICG n = 17 | No ICG n = 17 | p-Value 1 | |
---|---|---|---|---|
Age, years | 60.9 ± 11.2 | 62.7 ± 9.9 | 59.1 ± 12.4 | 0.360 |
Gender, n (%) | 0.714 | |||
Male | 23 (67.7) | 11 (64.7) | 12 (70.6) | |
Female | 11 (32.4) | 6 (35.3) | 5 (29.4) | |
Tumor size, mm3 | 7802 (2577–11,261) | 5130 (2344–6026) | 10,473 (3753–16,273) | 0.041 |
Knosp classification, n (%) | 0.764 | |||
0 | 3 (8.8) | 2 (11.8) | 1 (5.9) | |
1 | 18 (52.9) | 8 (47.1) | 10 (58.8) | |
2 | 8 (23.5) | 5 (29.4) | 3 (17.6) | |
3 | 5 (14.7) | 2 (11.8) | 3 (17.6) | |
Hardy classification, n (%) | 0.817 | |||
1 | 5 (14.7) | 3 (17.6) | 2 (11.8) | |
2 | 9 (26.5) | 4 (23.5) | 5 (29.4) | |
3 | 10 (29.4) | 6 (35.3) | 4 (23.5) | |
4 | 10 (29.4) | 4 (23.5) | 6 (35.3) |
ICG Group | No ICG Group | p1 | p2 | p3 | |||||
---|---|---|---|---|---|---|---|---|---|
Pre-OP | Post-OP | 3–6 Months Post-OP | Pre-OP | Post-OP | 3–6 Months Post-OP | ICG vs. No ICG | Control Measurement | Interaction | |
Fluid balance, n (%) | 0.210 | 0.116 | 0.258 | ||||||
No complication | 17/17 (100) | 12/17 (70.6) | 16/17 (94.1) | 17/17 (100) | 12/17 (70.6) | 13/17 (76.5) | |||
Complication | 0/17 (0) | 5/17 (29.4) | 1/17 (5.9) | 0/17 (0) | 5/17 (29.4) | 4/17 (23.5) | |||
Fluid balance complication, n (%) | - | - | |||||||
Diabetes insipidus | - | 3/5 | 1/1 | - | 4/5 | 4/4 | 0.148 | 0.399 | 0.399 |
SIADH | - | 2/5 | 0/1 | - | 1/5 | 0/4 | - | - |
ICG n = 17 | No ICG n = 17 | p-Value 1 | |
---|---|---|---|
HP before OP, n (%) | 0.3 | ||
No | 8 (47.1) | 6 (35.3) | |
Yes | 9 (52.9) | 11 (64.7) | |
HP after OP, n (%) | - | ||
No | 0 (0) | 0 (0) | |
Yes | 17 (100) | 17 (100) | |
HP 3–6 months after OP 2, n (%) | 0.822 | ||
Not detectable | 5/17 (33.3) | 3/17 (18.8) | |
Improvement | 2/17 (13.3) | 2/17 (12.5) | |
As after OP (HP already before OP) | 1/17(6.7) | 3/17 (12.5) | |
After OP (HP occurs after OP) | 1/17 (6.7) | 3/17 (18.8) | |
Deterioration | 8/17 (40.0) | 6/17 (37.5) | |
HP 3–6 months after OP 3, n (%) | 1 | ||
Improvement | 1/17 (5.9) | 1/17 (5.9) | |
Steady state | 6/17 (35.3) | 6/17 (35.3) | |
Deterioration | 10/17 (58.8) | 10/17 (58.8) |
Number of Axes Affected | Before OP | 3–6 Months after OP | ||||
---|---|---|---|---|---|---|
Total | ICG | No ICG | Total | ICG | No ICG | |
0 | 14 (41.2) | 8 (47.1) | 6 (35.3) | 8 (23.5) | 5 (29.4) | 3 (17.6) |
1 | 5 (14.7) | 2 (11.8) | 3 (17.6) | 6 (17.6) | 3 (17.6) | 3 (17.6) |
2 | 10 (29.4) | 3 (17.6) | 7 (41.2) | 7 (20.6) | 0 (0) | 7 (41.2) |
3 | 3 (8.8) | 3 (17.6) | 0 (0) | 10 (29.4) | 8 (47.1) | 2 (11.8) |
4 | 2 (5.9) | 1 (5.9) | 1 (5.9) | 3 (8.8) | 1 (5.9) | 2 (11.8) |
p-value | 0.3 | 0.013 |
Number of Axes Affected | Before OP | 3–6 Months after OP | p2 | ||||||
---|---|---|---|---|---|---|---|---|---|
Total | ICG | No ICG | p1 | Total | ICG | No ICG | p1 | ||
Average ± SE | 1.24 ± 0.22 | 1.24 ± 0.34 | 1.24 ± 0.28 | 1 | 1.82 ± 0.23 | 1.82 ± 0.36 | 1.82 ± 0.30 | 1 | 0.003 |
Median (first, third quartile) | 1 (0, 2) | 1 (0, 2.5) | 1 (0, 2) | 0.919 | 2 (0.75, 3) | 3 (0, 3) | 2 (1, 2.5) | 0.892 | 0.003 |
Axis Type | Before OP | 3–6 Months after OP | ||||
---|---|---|---|---|---|---|
Total | ICG | No ICG | Total | ICG | No ICG | |
Tyroid axis | 15 | 8 | 7 | 19 | 9 | 10 |
Adrenal axis | 10 | 5 | 5 | 18 | 10 | 8 |
Gonadal axis | 14 | 7 | 7 | 18 | 9 | 9 |
Somatotropic axis | 2 | 1 | 1 | 7 | 3 | 4 |
Prolactin axis | 0 | 0 | 0 | 0 | 0 | 0 |
Factor | Hypopituitarism | Diabetes Insipidus | ||
---|---|---|---|---|
OR (95 % CI) | p | OR (95 % CI) | p | |
Age | 1.04 (0.96–1.12) | 0.337 | 1.03 (0.94–1.13) | 0.518 |
Gender | 2.86 (0.53–16.67) | 0.223 | 2.18 (0.20–23.79) | 0.522 |
Tumor size | 1.00 (0.99–1.00) | 0.101 | 1.00 (1.00–1.00) | 0.169 |
Knosp | 4.15 (0.96–17.86) | 0.056 | 0.59 (0.16–2.13) | 0.418 |
Hardy | 2.48 (0.90–6.76) | 0.078 | 0.53 (0.18–1.52) | 0.235 |
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Felbabić, T.; Velnar, T.; Kocjan, T. Hypopituitarism, Diabetes Insipidus, and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Pituitary Macroadenoma Surgery with Indocyanine Green Dye. Diagnostics 2024, 14, 1863. https://doi.org/10.3390/diagnostics14171863
Felbabić T, Velnar T, Kocjan T. Hypopituitarism, Diabetes Insipidus, and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Pituitary Macroadenoma Surgery with Indocyanine Green Dye. Diagnostics. 2024; 14(17):1863. https://doi.org/10.3390/diagnostics14171863
Chicago/Turabian StyleFelbabić, Tomislav, Tomaž Velnar, and Tomaž Kocjan. 2024. "Hypopituitarism, Diabetes Insipidus, and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Pituitary Macroadenoma Surgery with Indocyanine Green Dye" Diagnostics 14, no. 17: 1863. https://doi.org/10.3390/diagnostics14171863