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J Neurol Surg B Skull Base 2023; 84(06): 578-584
DOI: 10.1055/a-1924-9736
Original Article

Postoperative Serum C-Reactive Protein and Cerebrospinal Fluid Leakage after Endoscopic Transsphenoidal Surgery

Rei Yamaguchi
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Masahiko Tosaka
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Naoto Mukada
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Haruka Tsuneoka
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Hiroya Shimauchi-Otaki
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Takaaki Miyagishima
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Fumiaki Honda
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
,
Yuhei Yoshimoto
1   Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
› Institutsangaben Funding None.
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Abstract

Objective Postoperative cerebrospinal fluid (CSF) leakage in endoscopic transsphenoidal surgery is a potential risk that requires immediate repair. We investigated the potential of common postoperative hematological examinations for diagnosing postoperative CSF leakage.

Methods We retrospectively studied 214 consecutive cases who underwent endoscopic transsphenoidal approach (ETSA; transsellar approach) or extended ETSA (E-ETSA). Patients with postoperative CSF leakage were defined the leak group (group L), and patients without were defined as the nonleak group (group N). Postoperative C-reactive protein (CRP) was compared between the ETSA and E-ETSA groups, and between the N and L groups.

Results The values of white blood cell count and CRP 1 to 7 days after surgery were significantly higher in the L group. Especially, CRP was clearly elevated in the L group (p < 0.001). The CRP value was higher in patients in the N group after E-ETSA than after ETSA (p < 0.001). CRP increased on the day after surgery but decreased gradually thereafter in patients after ETSA and in the N group. In contrast, CRP value tended to increase gradually after surgery in the L group. In particular, the CRP on the day before the CSF leak was confirmed was clearly higher than on the fifth to seventh days in the N group.

Conclusion Elevated CRP after endoscopic endonasal transsphenoidal surgery is a potential marker of CSF leakage.

Keywords

endoscopic transsphenoidal surgery - cerebrospinal fluid leakage - inflammation marker - C-reactive protein - extended transsphenoidal surgery


Publikationsverlauf

Eingereicht: 10. April 2022

Angenommen: 03. August 2022

Accepted Manuscript online:
16. August 2022

Artikel online veröffentlicht:
14. September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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