Factors Influencing Cerebrospinal Fluid Leaking following Pituitary Adenoma Transsphenoidal Surgery: A Meta-Analysis and Comprehensive Review

Abstract

Background. Surgical resection is the main method to treat pituitary adenoma. Cerebrospinal fluid leakage (CSF Leak) is the main complication after transsphenoidal surgery. The impact of postoperative CSF Leak can be predicted in advance, and preventive measures can be taken in time. Clinically, a variety of factors may affect the occurrence of postoperative CSF Leak. In this study, meta-analysis was used to investigate the risk factors of postoperative CSF Leak as a clinical reference. Methods. The databases PubMed, Medline, Embrase, Cochrane library, CNKI, and CBM were searched for all studies on the risk factors of postoperative CSF Leak. Studies were screened and finally included. The quality of the included studies was assessed by the Newcastle-Ottawa scale. We used Revman 5.4 software to conduct the pooled effect size of every potential statistically significant factor. Results. 13 articles with a total of 5967 patients with pituitary adenoma and 405 cases of postoperative CSF Leak were finally included, accounting for 6.79%. All of the 13 articles had a quality score > 5 , indicating good quality. Meta-analysis showed that patient age ( OR = 0.71 , 95% CI (0.41, 1.20), P = 0.20 ) was not a factor influencing postoperative CSF Leak, while BMI ( MD = 2.26 , 95% CI (1.31, 3.20), P < 0.00001 ), tumor size ( MD = 1.35 , 95% CI (0.22, 2.49), P = 0.02 ), whether a second operation was performed ( OR = 2.20 , 95% CI (1.45, 3.33), P = 0.0002 ), and intraoperative CSF Leak ( OR = 8.88 , 95% CI (3.64, 21.69), P < 0.00001 ) were risk factors for postoperative CSF Leak in patients. Discussion. BMI, tumor size, reoperation, and intraoperative CSF Leak are the risk factors of postoperative CSF Leak. However, not all the factors were covered in this study, it is still worth continuing to deeply investigate in this topic.

Mayo Clinic Clival Chordoma Case Series: Impact of Endoscopic Training on Clinical Care

“…In another study, CSF leaks were associated with large tumor volume and level of tumor invasiveness [ 12 ]. One meta-analysis on post-operative CSF leak risk factors after pituitary adenoma transsphenoidal surgery showed body mass index, tumor size, revision surgery, and intraoperative CSF leak as significant factors [ 13 ]. However, none of these factors were significant in our cohort.…”

Machine learning driven prediction of cerebrospinal fluid rhinorrhoea following endonasal skull base surgery: A multicentre prospective observational study

“…In brief, it is a multicentre dataset (30 centres in the UK and Ireland), collected via a prospective observational study in 3 phases encompassing November 2019 – July 2020 ( 22 – 25 ). All TSA (defined as transsphenoidal access to the sella alone) and EEA [defined as acquiring surgical access to an area beyond the sella ( 17 , 19 )] were included. The dataset is composed of baseline characteristic data (e.g., age; sex; tumour diameter), operative data (e.g., intraoperative CSF leak presence; skull base repair method) and postoperative outcomes (e.g., CSFR) ( 22 – 25 ).…”

“…Numerous risk factors have been identified for CSFR, including the presence of intraoperative cerebrospinal fluid (CSF) leak; revision surgery; and high body mass index (BMI) ( 19 ). A particularly important factor is the choice of skull base repair technique used intraoperatively ( 7 , 10 , 13 , 16 , 20 ).…”

Retracted: Factors Influencing Cerebrospinal Fluid Leaking following Pituitary Adenoma Transsphenoidal Surgery: A Meta-Analysis and Comprehensive Review

“…BioMed Research International has retracted the article titled "Factors Influencing Cerebrospinal Fluid Leaking following Pituitary Adenoma Transsphenoidal Surgery: A Meta-Analysis and Comprehensive Review" [1] due to concerns that the peer review process has been compromised. Following an investigation conducted by the Hindawi Research Integrity team [2], significant concerns were identified with the peer reviewers assigned to this article; the investigation has concluded that the peer review process was compromised.…”

“…BioMed Research International has retracted the article titled “Factors Influencing Cerebrospinal Fluid Leaking following Pituitary Adenoma Transsphenoidal Surgery: A Meta-Analysis and Comprehensive Review” [ 1 ] due to concerns that the peer review process has been compromised.…”