Abstract：
Hydrocephalus is one of the most significant comorbidities of pediatric suprasellar tumors. Up to 37.5-68.0% of patients were diagnosed with hydrocephalus at admission. However, after surgical resection of the tumor, 9.3-51.4% of the hydrocephalus will persist and require a ventriculoperitoneal shunt (VPS) surgery. The purpose of this study was to identify the risk factors associated with postresection shunting in children with suprasellar tumors.
We conducted a retrospective analysis of children who underwent surgery for suprasellar tumors at our department from February 2011 to December 2020. We used univariate and multivariate analysis to screen the factors that might be correlated with postoperative shunt placement, taking into account patients\' characteristics, tumor histology/size/calcification, the severity of preoperative hydrocephalus, the involvement of ventricles, external ventricular drainage (EVD) placement, postoperative intraventricular hematoma, the extent of resection, and other surgical details.
A total of 124 children who underwent surgery for suprasellar tumors were included in our study. Hydrocephalus was present in 55 patients (44.3%) at admission; 23 patients (18.5%) received VPS implantation after tumor removal. Univariate analysis showed that the involvement of ventricles (p = 0.002), moderate/severe preoperative hydrocephalus (p = 0.001), postoperative intraventricular hematoma (p = 0.005), and EVD implantation (p = 0.001) were significantly associated with postoperative VPS. Multivariate analysis confirmed that only ventricle involvement (p = 0.002; OR = 5.6; 95%CI 1.8-17.2) and intraventricular hematoma (p = 0.01; OR = 10.7; 95%CI 1.8-64.2) were independent risk factors for postresection shunting.
Ventricle involvement and intraventricular hematoma can be identified as independent predictors for postoperative shunting in pediatric suprasellar tumors.
We conducted a retrospective analysis of children who underwent surgery for suprasellar tumors at our department from February 2011 to December 2020. We used univariate and multivariate analysis to screen the factors that might be correlated with postoperative shunt placement, taking into account patients\' characteristics, tumor histology/size/calcification, the severity of preoperative hydrocephalus, the involvement of ventricles, external ventricular drainage (EVD) placement, postoperative intraventricular hematoma, the extent of resection, and other surgical details.
A total of 124 children who underwent surgery for suprasellar tumors were included in our study. Hydrocephalus was present in 55 patients (44.3%) at admission; 23 patients (18.5%) received VPS implantation after tumor removal. Univariate analysis showed that the involvement of ventricles (p = 0.002), moderate/severe preoperative hydrocephalus (p = 0.001), postoperative intraventricular hematoma (p = 0.005), and EVD implantation (p = 0.001) were significantly associated with postoperative VPS. Multivariate analysis confirmed that only ventricle involvement (p = 0.002; OR = 5.6; 95%CI 1.8-17.2) and intraventricular hematoma (p = 0.01; OR = 10.7; 95%CI 1.8-64.2) were independent risk factors for postresection shunting.
Ventricle involvement and intraventricular hematoma can be identified as independent predictors for postoperative shunting in pediatric suprasellar tumors.
摘要：
脑积水是小儿鞍上肿瘤最重要的合并症之一。高达37.5-68.0％的患者在入院时被诊断为脑积水。然而,手术切除肿瘤后，9.3-51.4％的脑积水将持续存在，需要进行脑室腹膜分流术（VPS）手术。这项研究的目的是确定与鞍上肿瘤患儿切除术后分流相关的危险因素。
我们对2011年2月至2020年12月在我科接受鞍上肿瘤手术的儿童进行了回顾性分析。我们使用单变量和多变量分析来筛选可能与术后分流安置相关的因素。考虑到患者的特征，肿瘤组织学/大小/钙化，术前脑积水的严重程度，心室的受累，脑室外引流（EVD）放置，术后脑室血肿，切除的程度，和其他手术细节。
总共124例接受鞍上肿瘤手术的儿童被纳入本研究。入院时出现脑积水55例（44.3％）；23例（18.5％）在肿瘤切除后接受了VPS植入。单因素分析显示心室受累(p=0.002),术前中度/重度脑积水（p=0.001），术后脑室血肿（p=0.005），和EVD植入(p=0.001)与术后VPS显著相关。多因素分析证实，只有脑室受累（p=0.002；OR=5.6；95CI1.8-17.2）和脑室血肿（p=0.01；OR=10.7；95CI1.8-64.2）是术后分流的独立危险因素。
脑室受累和脑室内血肿可作为小儿鞍上肿瘤术后分流的独立预测因子。
我们对2011年2月至2020年12月在我科接受鞍上肿瘤手术的儿童进行了回顾性分析。我们使用单变量和多变量分析来筛选可能与术后分流安置相关的因素。考虑到患者的特征，肿瘤组织学/大小/钙化，术前脑积水的严重程度，心室的受累，脑室外引流（EVD）放置，术后脑室血肿，切除的程度，和其他手术细节。
总共124例接受鞍上肿瘤手术的儿童被纳入本研究。入院时出现脑积水55例（44.3％）；23例（18.5％）在肿瘤切除后接受了VPS植入。单因素分析显示心室受累(p=0.002),术前中度/重度脑积水（p=0.001），术后脑室血肿（p=0.005），和EVD植入(p=0.001)与术后VPS显著相关。多因素分析证实，只有脑室受累（p=0.002；OR=5.6；95CI1.8-17.2）和脑室血肿（p=0.01；OR=10.7；95CI1.8-64.2）是术后分流的独立危险因素。
脑室受累和脑室内血肿可作为小儿鞍上肿瘤术后分流的独立预测因子。
