Ultrasound assessment of gastric contents and volume in patients undergoing endoscopic endonasal transsphenoidal surgery: a prospective observational study

Intraoperative ingestion of blood, cerebrospinal fluid, and irrigation fluid can lead to an increase in gastric volume, resulting in the potential risk of aspiration in patients after endoscopic endonasal transsphenoidal surgery (EETS). In this prospective observational study, we aimed to assess the...

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Bibliographic Details
Published in:	Scientific reports 2023-02, Vol.13 (1), p.2848-2848, Article 2848
Main Authors:	Jia, Haitao, He, Ertao, Gao, Shixiong, Hao, Wei, Li, Yanli, Liu, Wei, Chen, Xiaoxia, Jia, Yanfei, Wang, Yingbin
Format:	Article
Language:	eng
Subjects:	Adenoma Aged Cerebrospinal fluid Diabetes mellitus Endoscopy Humans Neurosurgery Observational studies Pituitary Prospective Studies Pyloric Antrum Risk factors Stomach - diagnostic imaging Stomach - surgery Surgery Ultrasonic imaging Ultrasonography - methods Ultrasound
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Summary:	Intraoperative ingestion of blood, cerebrospinal fluid, and irrigation fluid can lead to an increase in gastric volume, resulting in the potential risk of aspiration in patients after endoscopic endonasal transsphenoidal surgery (EETS). In this prospective observational study, we aimed to assess the volume of gastric contents in patients undergoing this neurosurgical procedure using ultrasound, and to determine the factors associated with volume change. Eighty-two patients diagnosed with pituitary adenoma were recruited consecutively. Semi-quantitative (Perlas scores: 0, 1 and 2) and quantitative (cross-sectional area, CSA) ultrasound assessments of the gastric antrum were performed immediately before and after surgery in the semi-recumbent and semi-recumbent right-lateral positions. Seven (8.5%) patients had antrum scores from preoperative grade 0 to postoperative grade 2; nine (11%) patients had antrum scores from preoperative grade 0 to postoperative grade 1. The mean ± standard deviation (SD) of increased gastric volume was 71.0 ± 33.1 mL and 236.5 ± 32.4 mL in postoperative grade 1 and 2 groups, respectively. Subgroup analysis showed that 11 (13.4%) patients (4 in grade 1 and all in grade 2) had postoperative estimated gastric volume > 1.5 mL kg (mean ± SD 3.08 ± 1.67, range 1.51-5.01 mL kg ). Logistic regression analysis revealed that older age, diabetes mellitus, and long surgical duration were independent risk factors for significant volume change (all P
ISSN:	2045-2322 2045-2322