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Postoperative Management After Pituitary Surgery

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Handbook of Inpatient Endocrinology

Abstract

All patients should ideally be seen by an endocrinologist before admission for transsphenoidal pituitary surgery. Once admitted, hormone evaluation for cortisol status is the most important test. Depending on the preoperative cortisol adequacy, insufficiency, excess, or unknown status, perioperative and postoperative treatment with hydrocortisone is often indicated. Peri- and postoperative treatment should also include monitoring and treatment for diabetes insipidus or inappropriate secretion of antidiuretic hormone. Close monitoring of water and sodium balance is required. Finally, the patient should follow up with an endocrinologist 1–2 weeks after surgery so that pituitary hormone status can be reevaluated and proper treatment and follow-up arranged.

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  • Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH. Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metabol. 2016;101(11):3888–921.

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  • Woodmansee WW, Carmichael J, Kelly D, Katznelson L. AACE Neuroendocrine and Pituitary Scientific Committee. American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: Postoperative Management Following Pituitary Surgery. Endocr Pract. 2015;21(7):832–8.

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  • Ziu M, Dunn IF, Hess C, Fleseriu M, Bodach ME, Tumialan LM, et al. Congress of neurological surgeons systematic review and evidence-based guideline on posttreatment follow-up evaluation of patients with nonfunctioning pituitary adenomas. Neurosurgery. 2016;79(4):E541–3.

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Correspondence to Anna Zelfond Feldman .

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Feldman, A.Z., Hartzband, P. (2020). Postoperative Management After Pituitary Surgery. In: Garg, R., Hennessey, J., Malabanan, A., Garber, J. (eds) Handbook of Inpatient Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-38976-5_3

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  • DOI: https://doi.org/10.1007/978-3-030-38976-5_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-38975-8

  • Online ISBN: 978-3-030-38976-5

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