Evidence map›Paper›PMID 42165967›Full record

ArticleJournal of neuro-oncology2026

Risk factors for postoperative cerebrospinal fluid leak following endoscopic transsphenoidal surgery for craniopharyngioma: a multicenter cohort study with a contemporary surgeon practice survey.

Sandhya R Palit, Yuki Shinya, Maria Peris Celda, Michael Karsy, James J Evans, Michael R Chicoine, Albert H Kim, Bhuvic Patel, Won Kim, Marvin Bergsneider and 25 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

35 authors.

Sandhya R PalitDepartment of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
Yuki ShinyaDepartment of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
Maria Peris CeldaDepartment of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
Michael KarsyDepartment of Neurosurgery, University of Michigan Health, Ann Arbor, MI, USA.
James J EvansDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Michael R ChicoineDepartment of Neurological Surgery, University of Missouri Health Care, Columbia, MO, USA.
Albert H KimDepartment of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
Bhuvic PatelDepartment of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
Won KimDepartment of Neurosurgery, UCLA Health, Los Angeles, CA, USA.
Marvin BergsneiderDepartment of Neurosurgery, UCLA Health, Los Angeles, CA, USA.
Donato R PacioneDepartment of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA.
Paul GardnerDepartment of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA.
Debraj MukherjeeDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Connor LiuDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stephanie CheokDepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Nathan T ZwagermanDepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Charles ChristensonDepartment of Neurosurgery, McGovern Medical School at UTHealth Houston, Houston, TX, USA.
Spiros BlackburnDepartment of Neurosurgery, McGovern Medical School at UTHealth Houston, Houston, TX, USA.
Varun R KshettryDepartment of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
Robert C RennertDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah Health, Salt Lake City, UT, USA.
William T CouldwellDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah Health, Salt Lake City, UT, USA.
Ramin MorshedDepartment of Neurological Surgery, University of California, San Francisco (UCSF), San Francisco, CA, USA.
Kyle C WuDepartment of Neurological Surgery, The Ohio State University, Columbus, OH, USA.
Daniel PrevedelloDepartment of Neurological Surgery, The Ohio State University, Columbus, OH, USA.
Garni BarkhoudarianDepartment of Neurosurgery, Pacific Neuroscience Institute, Santa Monica, CA, USA.
Juan C Fernandez-MirandaDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
Gabriel ZadaDepartment of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Carolina BenjaminDepartment of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Michael P CatalinoDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
Adam MamelakDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Andre Beer FurlanDepartment of Neuro-Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Georgios ZenonosDepartment of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Michelle Magaña MendozaDepartment of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Andrew S LittleDepartment of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Jamie J Van GompelDepartment of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA. Vangompel.jamie@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis multicenter, multi-surgeon retrospective study aimed to identify risk factors for postoperative cerebrospinal fluid (CSF) leak following endonasal resection of craniopharyngioma, while evaluating the "perception gap" through a surgeon survey.

methodsA retrospective review was conducted on 416 patients who underwent endoscopic transsphenoidal surgery (ETS) for craniopharyngioma from 20 institutions. Factors were compared between patients with and without postoperative CSF leak, and between Early (2007-2015) and Late (2016-2025) Epochs. Complementing the clinical data, a survey of 19 neurosurgeons captured expert perspectives on risk stratification and management strategies.

resultsOverall postoperative CSF leak rate was 13.5% (56/416 patients). Univariate analysis identified predominantly cystic tumors (34% vs. 21%, p = 0.034) and intraoperative lumbar drain (LD) use (p < 0.028) as associated with postoperative CSF leak. BMI (p = 0.587), prior surgery (p = 0.576), and tumor size (p = 0.363) were not significant. In the multivariable analysis, LD use was associated with a higher postoperative CSF leak rate (OR 1.91, 95% CI 1.06-3.46; p = 0.030). Between Epochs, nasoseptal flap (NSF) utilization increased from 70.7% to 87.6% (p < 0.001). NSF was protective (OR 0.28, 95% CI 0.07-0.92; p = 0.037) in the Early Epoch; no factors were significant in the Late Epoch. The surgeons' survey identified prior surgery and intraoperative high flow leaks as primary risks; however, their LD protocols diverged from clinical data.

conclusionPostoperative CSF leak in Craniopharyngioma has evolved. The study highlights a significant divergence between expert perception and clinical data regarding lumbar drains.

Indexed as

Cerebrospinal Fluid LeakCraniopharyngiomaNeuroendoscopyPituitary NeoplasmsPostoperative ComplicationsAdolescentAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesRisk FactorsSurveys and QuestionnairesCraniopharyngiomaCSF leakEndoscopic transsphenoidal surgerySkull base reconstructionSurgeon surveySurgical practice

Identifiers

PMID42165967

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.