title: Frequent occurrence of the triphasic response (diabetes insipidus/hyponatremia/diabetes insipidus) after surgery for craniopharyngioma in childhood.
abstract: OBJECTIVE
  It is not exactly known how many children develop the triphasic response (diabetes insipidus (DI)/hyponatremia/DI) immediately after surgery for childhood craniopharyngioma; neither is it known which factors predict this. We studied the occurrence of the triphasic response after primary surgery for craniopharyngioma in children, and aimed to identify possible predictors.
  
  
  METHODS
  Patients <18 years old who had undergone a primary craniopharyngioma resection between January 1990 and February 2010 in either of the 2 academic centers in Amsterdam were studied retrospectively.
  
  
  RESULTS
  Twenty-one patients (5 males) fulfilled the inclusion criteria. Median age at surgery was 9.1 (range: 4.0-15.1) years. Six patients developed a triphasic response (29%). Of all factors, only the duration of surgery was found to be a predictor of a triphasic response: 8.5 (6.0-11.0) versus 4.6 (3.5-11.5) h in patients who did not develop a triphasic response (p = 0.03).
  
  
  CONCLUSIONS
  After primary surgery for a craniopharyngioma, a considerable number of patients develop a triphasic response in the regulation of the sodium and water balance. This is predicted by (factors associated with) a longer duration of surgery. Other predictors could not be identified, which may be due to the small sample size.
authors.affiliation: Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands. m.finken@vumc.nl
authors.forename: Martijn J J
authors.initials: MJ
authors.lastname: Finken
authors.forename: Nitash
authors.initials: N
authors.lastname: Zwaveling-Soonawala
authors.forename: Marie J E
authors.initials: MJ
authors.lastname: Walenkamp
authors.forename: Thomas
authors.initials: T
authors.lastname: Vulsma
authors.forename: A S Paul
authors.initials: AS
authors.lastname: van Trotsenburg
authors.forename: Joost
authors.initials: J
authors.lastname: Rotteveel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000150:complications* / Q000601:surgery; D003919:Diabetes Insipidus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors