Abstract：
OBJECTIVE: Central diabetes insipidus or vasopressin deficiency (AVP-D) is the most frequent water balance disorder after transsphenoidal surgery (TSS) with variable prevalence amongst studies. We aimed to determine rates of newly developed transient or permanent AVP-D in patients with pituitary tumours treated with TSS.
METHODS: We performed systematic review of Medline, Embase, and Cochrane Library between January 1, 2000 and January 31, 2021 for studies reporting on outcomes for pituitary adenoma, craniopharyngioma, and Rathke\'s cleft cyst (RCC) after TSS and providing definition of post-operative AVP-D. We pooled the results as proportions with 95% confidence intervals (CIs) using Freeman-Tukey transformation random effects meta-analysis.
RESULTS: From 11 694 studies, 51 were included. Rates of transient or permanent AVP-D were: 17% (95% CI, 13-21) and 3% (95% CI, 2-5) in total group, 16% (95% CI, 12-21) and 2% (95% CI, 2-3) in pituitary adenomas, 31% (95% CI, 24-39) and 30% (95% CI, 22-39) in craniopharyngiomas, and 35% (95% CI, 16-57) and 14% (95% CI, 6-23) in RCCs, respectively. Based on diagnostic criteria, rates of transient or permanent AVP-D were: For hypotonic polyuria, 14% (95% CI, 8-22) and 3% (95% CI, 1-4), for hypotonic polyuria and hypernatraemia, 21% (95% CI, 13-29) and 5% (95% CI, 2-11), and for desmopressin administration, 22% (95% CI, 15-29) and 9% (95% CI, 0-30), respectively.
CONCLUSIONS: Following TSS, a small proportion of patients with pituitary adenoma have permanent AVP-D (2%), but prevalence reaches 30% in ones with craniopharyngioma and 14% in those with RCC. Diagnostic criteria for post-operative AVP-D remain variable affecting reported rates of this condition.
METHODS: We performed systematic review of Medline, Embase, and Cochrane Library between January 1, 2000 and January 31, 2021 for studies reporting on outcomes for pituitary adenoma, craniopharyngioma, and Rathke\'s cleft cyst (RCC) after TSS and providing definition of post-operative AVP-D. We pooled the results as proportions with 95% confidence intervals (CIs) using Freeman-Tukey transformation random effects meta-analysis.
RESULTS: From 11 694 studies, 51 were included. Rates of transient or permanent AVP-D were: 17% (95% CI, 13-21) and 3% (95% CI, 2-5) in total group, 16% (95% CI, 12-21) and 2% (95% CI, 2-3) in pituitary adenomas, 31% (95% CI, 24-39) and 30% (95% CI, 22-39) in craniopharyngiomas, and 35% (95% CI, 16-57) and 14% (95% CI, 6-23) in RCCs, respectively. Based on diagnostic criteria, rates of transient or permanent AVP-D were: For hypotonic polyuria, 14% (95% CI, 8-22) and 3% (95% CI, 1-4), for hypotonic polyuria and hypernatraemia, 21% (95% CI, 13-29) and 5% (95% CI, 2-11), and for desmopressin administration, 22% (95% CI, 15-29) and 9% (95% CI, 0-30), respectively.
CONCLUSIONS: Following TSS, a small proportion of patients with pituitary adenoma have permanent AVP-D (2%), but prevalence reaches 30% in ones with craniopharyngioma and 14% in those with RCC. Diagnostic criteria for post-operative AVP-D remain variable affecting reported rates of this condition.
摘要：
目的：中心性尿崩症或加压素缺乏症（AVP-D）是经蝶窦手术（TSS）后最常见的水分平衡障碍，在研究中患病率不同。我们旨在确定使用TSS治疗的垂体肿瘤患者中新出现的短暂性或永久性AVP-D的发生率。
方法：我们对Medline，Embase和CochraneLibrary于2000/01-2021/01/01/31之间进行，用于报告垂体腺瘤结局的研究，TSS术后颅咽管瘤和Rathke裂隙囊肿（RCC），并提供术后AVP-D的定义。我们使用Freeman-Tukey转化随机效应荟萃分析将结果合并为具有95％置信区间（CI）的比例。
结果：来自11694项研究，包括51个。短暂性或永久性AVP-D的发生率为：全组的17％（95％CI，13-21）和3％（95％CI，2-5），16％（95％CI，12-21）和2％（95％CI，2-3）在垂体腺瘤，颅咽管瘤的31%（95%CI，24-39）和30%（95%CI，22-39），RCC中35%(95%CI，16-57)和14%(95%CI，6-23)，分别。根据诊断标准，短暂性或永久性AVP-D的发生率为：低渗多尿，14%(95%CI，8-22)和3%(95%CI，1-4)，低渗多尿和高钠血症，21%（95%CI，13-29）和5%（95%CI，2-11），去氨加压素给药，22%（95%CI，15-29）和9%（95%CI，0-30），分别。
结论：在TSS之后，一小部分垂体腺瘤患者具有永久性AVP-D（2％），但是颅咽管瘤的患病率达到30％，RCC的患病率达到14％。术后AVP-D的诊断标准仍然可变，影响报告的这种情况的发生率。
方法：我们对Medline，Embase和CochraneLibrary于2000/01-2021/01/01/31之间进行，用于报告垂体腺瘤结局的研究，TSS术后颅咽管瘤和Rathke裂隙囊肿（RCC），并提供术后AVP-D的定义。我们使用Freeman-Tukey转化随机效应荟萃分析将结果合并为具有95％置信区间（CI）的比例。
结果：来自11694项研究，包括51个。短暂性或永久性AVP-D的发生率为：全组的17％（95％CI，13-21）和3％（95％CI，2-5），16％（95％CI，12-21）和2％（95％CI，2-3）在垂体腺瘤，颅咽管瘤的31%（95%CI，24-39）和30%（95%CI，22-39），RCC中35%(95%CI，16-57)和14%(95%CI，6-23)，分别。根据诊断标准，短暂性或永久性AVP-D的发生率为：低渗多尿，14%(95%CI，8-22)和3%(95%CI，1-4)，低渗多尿和高钠血症，21%（95%CI，13-29）和5%（95%CI，2-11），去氨加压素给药，22%（95%CI，15-29）和9%（95%CI，0-30），分别。
结论：在TSS之后，一小部分垂体腺瘤患者具有永久性AVP-D（2％），但是颅咽管瘤的患病率达到30％，RCC的患病率达到14％。术后AVP-D的诊断标准仍然可变，影响报告的这种情况的发生率。
