Wang Lei, Liu Shanxian, Zheng Jie, Li Rui, Xing Zhenyi
Department of Neurosurgery, Xinxiang Central Hospital, 56 Jinsui Avenue, Weibin District, Xinxiang, 453000, Henan, China.
Sci Rep. 2025 Jan 23;15(1):2995. doi: 10.1038/s41598-025-86567-x.
Pituitary Neuroendocrine Tumors (PitNETs), often treated via endonasal transsphenoidal resection, present a risk for postoperative surgical site infections (SSIs), including intracranial infections such as meningitis. Identifying the risk factors associated with these infections is crucial for improving surgical outcomes and patient care. A retrospective study was conducted at a medical center from June 2020 to June 2023. The study included 20 patients with postoperative intracranial infections and 50 controls without infections. Inclusion criteria involved adult patients diagnosed with PitNETs who underwent standard endonasal transsphenoidal surgery and provided informed consent. Exclusion criteria included previous neurosurgical procedures, preoperative infections, concurrent severe diseases, or alternative surgical approaches. Diagnostic criteria for intracranial infections were based on clinical, hematological, cerebrospinal fluid, radiological, and microbiological findings. Statistical analyses were performed using IBM SPSS, focusing on univariate and multivariate logistic regression analyses. Univariate analysis showed no significant association of intracranial infections with factors like smoking history, previous craniotomy, operation time, hypertension, preoperative sphenoid sinusitis, BMI, and age. However, postoperative CSF leaks, intracranial pneumocephalus, diabetes mellitus, and tumor extension to the third ventricle were significantly associated with infections. Multivariate logistic regression further confirmed these findings, with significant odds ratios for these factors. The study reveals a significant correlation between postoperative CSF leaks, intracranial pneumocephalus, diabetes mellitus, and tumor extension to the third ventricle with the occurrence of SSIs following endonasal transsphenoidal resection of PitNETs. Microbial analysis revealed Escherichia coli as the most prevalent pathogen in post-surgery infections, with notable antibiotic resistance patterns observed in key bacteria, necessitating careful antibiotic selection. Tailored clinical treatment strategies addressing these risk factors are essential to reduce the incidence of postoperative SSIs and enhance patient safety.
垂体神经内分泌肿瘤（PitNETs）通常通过鼻内镜经蝶窦切除术进行治疗，术后存在手术部位感染（SSIs）的风险，包括颅内感染如脑膜炎。识别与这些感染相关的风险因素对于改善手术效果和患者护理至关重要。2020年6月至2023年6月在一家医疗中心进行了一项回顾性研究。该研究纳入了20例术后颅内感染患者和50例未感染的对照患者。纳入标准包括诊断为PitNETs并接受标准鼻内镜经蝶窦手术且提供知情同意的成年患者。排除标准包括既往神经外科手术史、术前感染、并发严重疾病或替代手术入路。颅内感染的诊断标准基于临床、血液学、脑脊液、影像学和微生物学检查结果。使用IBM SPSS进行统计分析，重点是单因素和多因素逻辑回归分析。单因素分析显示颅内感染与吸烟史、既往开颅手术、手术时间、高血压、术前蝶窦炎、BMI和年龄等因素无显著相关性。然而，术后脑脊液漏、颅内积气、糖尿病和肿瘤延伸至第三脑室与感染显著相关。多因素逻辑回归进一步证实了这些发现，这些因素的优势比具有显著性。该研究揭示了鼻内镜经蝶窦切除PitNETs术后脑脊液漏、颅内积气、糖尿病和肿瘤延伸至第三脑室与手术部位感染的发生之间存在显著相关性。微生物分析显示大肠杆菌是术后感染中最常见的病原体，在关键细菌中观察到显著的抗生素耐药模式，因此需要谨慎选择抗生素。针对这些风险因素制定个性化的临床治疗策略对于降低术后SSIs的发生率和提高患者安全性至关重要。
