Frequent occurrence of the triphasic response (diabetes insipidus/hyponatremia/diabetes insipidus) after surgery for craniopharyngioma in childhood

Horm Res Paediatr. 2011;76(1):22-6. doi: 10.1159/000324115. Epub 2011 Jun 23.

Abstract

Background/aims: It is not exactly known how many children develop the triphasic response (diabetes insipidus (DI)/hyponatremia/DI) immediately after surgery for childhood craniopharyngioma; neither is it known which factors predict this. We studied the occurrence of the triphasic response after primary surgery for craniopharyngioma in children, and aimed to identify possible predictors.

Methods: Patients <18 years old who had undergone a primary craniopharyngioma resection between January 1990 and February 2010 in either of the 2 academic centers in Amsterdam were studied retrospectively.

Results: Twenty-one patients (5 males) fulfilled the inclusion criteria. Median age at surgery was 9.1 (range: 4.0-15.1) years. Six patients developed a triphasic response (29%). Of all factors, only the duration of surgery was found to be a predictor of a triphasic response: 8.5 (6.0-11.0) versus 4.6 (3.5-11.5) h in patients who did not develop a triphasic response (p = 0.03).

Conclusion: After primary surgery for a craniopharyngioma, a considerable number of patients develop a triphasic response in the regulation of the sodium and water balance. This is predicted by (factors associated with) a longer duration of surgery. Other predictors could not be identified, which may be due to the small sample size.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Craniopharyngioma / complications*
  • Craniopharyngioma / surgery
  • Diabetes Insipidus / epidemiology
  • Diabetes Insipidus / etiology*
  • Female
  • Humans
  • Hyponatremia / epidemiology
  • Hyponatremia / etiology*
  • Male
  • Netherlands / epidemiology
  • Neurosurgical Procedures / adverse effects
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / surgery
  • Postoperative Complications / epidemiology
  • Prevalence
  • Retrospective Studies
  • Time Factors