Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection

Abstract

Objective To 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. Methods The 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. Results Among 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. Conclusions There 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.

Risk factors and management associated with postoperative cerebrospinal fluid leak after endoscopic endonasal surgery for pituitary adenoma

“…CSF leak is one of the most common postoperative complications after EES for pituitary adenomas. According to literature reports, the incidence of CSF leak after EES for pituitary adenomas ranges from 2.6% to 12.1% (4,(11)(12)(13)(14)(15)(16)(17). In the current study, 3.5% of patients with pituitary adenomas developed cerebrospinal fluid leakage after EES.…”

Analysis of the Factors Related to Intracranial Infection after Brain Tumor Surgery

“…However, because the craniotomy of brain tumors is changed to invasive surgery, when the blood-brain barrier is damaged at the same time, it will lead to low immunity. erefore, foreign microorganisms and bacteria are more likely to invade and cause intracranial infection [7]. Intracranial infection will not only prolong the hospitalization time of patients but also increase the treatment cost.…”

Evaluating the Efficacy of a Novel Side-Support Surgical Tray Stand for Endoscopic Transnasal Skull Base Surgery: A Prospective Study

“…Endoscopic transnasal skull base surgery often involves either active or passive opening of the skull base dura, leading to communication between the intracranial and extracranial spaces, thereby increasing the risk of intracranial infections and other complications [ 6 - 7 ]. Properly reconstructing the skull base is critical for reducing postoperative cerebrospinal fluid leaks [ 8 , 9 ].…”