BACKGROUND Diabetes insipidus (DI) is a recognized transient or permanent complication following transsphenoidal surgery (TSS) for pituitary tumors. OBJECTIVE To describe significant experience with the incidence of DI after TSS, identifying predictive characteristics and describing our diagnosis and management of postoperative DI. METHODS A retrospective analysis was performed of 700 patients who underwent endoscopic TSS for resection of pituitary adenoma (PA), Rathke cleft cyst (RCC), or craniopharyngioma. Inclusion criteria included at least 1 wk of follow-up for diagnosis of postoperative DI. Permanent DI was defined as DI symptoms and/or need for desmopressin more than 1 yr postoperatively. All patients with at least 1 yr of follow-up (n = 345) were included in analyses of permanent DI. Multivariable logistic regression models were constructed to identify predictors of transient or permanent postoperative DI. RESULTS The overall rate of any postoperative DI was 14.7% (103/700). Permanent DI developed in 4.6% (16/345). The median follow-up was 10.7 mo (range: 0.2-136.6). Compared to patients with PA, patients with RCC (odds ratio [OR] = 2.2, 95% CI: 1.2-3.9; P = .009) and craniopharyngioma (OR = 7.0, 95% CI: 2.9-16.9; P ≤ .001) were more likely to develop postoperative DI. Furthermore, patients with RCC (OR = 6.1, 95% CI: 1.8-20.6; P = .004) or craniopharyngioma (OR = 18.8, 95% CI: 4.9-72.6; P ≤ .001) were more likely to develop permanent DI compared to those with PA. CONCLUSION Although transient DI is a relatively common complication of endoscopic and microscopic TSS, permanent DI is much less frequent. The underlying pathology is an important predictor of both occurrence and permanency of postoperative DI.

中文翻译：

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内窥镜经蝶手术后尿崩症

背景尿崩症（DI）是经蝶窦手术（TSS）治疗垂体瘤后公认的暂时性或永久性并发症。目的 描述 TSS 后 DI 发生率的重要经验，确定预测特征并描述我们对术后 DI 的诊断和管理。方法 对 700 例接受内镜 TSS 切除垂体腺瘤 (PA)、Rathke 裂囊肿 (RCC) 或颅咽管瘤的患者进行回顾性分析。纳入标准包括至少 1 周的随访以诊断术后 DI。永久性 DI 定义为术后 1 年以上出现 DI 症状和/或需要去氨加压素。所有至少随访 1 年的患者 (n = 345) 都包括在永久性 DI 的分析中。构建多变量逻辑回归模型来确定短暂或永久性术后 DI 的预测因素。结果 术后 DI 的总发生率为 14.7% (103/700)。永久性 DI 发生率为 4.6% (16/345)。中位随访时间为 10.7 个月（范围：0.2-136.6）。与 PA 患者相比，RCC 患者（比值比 [OR] = 2.2，95% CI：1.2-3.9；P = .009）和颅咽管瘤（OR = 7.0，95% CI：2.9-16.9；P ≤ .001 ) 更有可能发生术后 DI。此外，患有 RCC（OR = 6.1，95% CI：1.8-20.6；P = .004）或颅咽管瘤（OR = 18.8，95% CI：4.9-72.6；P ≤ .001）的患者更容易发生永久性 DI与那些有 PA 的人相比。结论 虽然短暂性 DI 是内镜和显微镜下 TSS 的一种相对常见的并发症，但永久性 DI 的频率要低得多。