2008
DOI: 10.1007/s11102-008-0086-6
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Postoperative assessment of the patient after transsphenoidal pituitary surgery

Abstract: While most transsphenoidal pituitary surgery is accomplished without complication, monitoring is required postoperatively for a set of disorders that are specific to this surgery. Postoperative assessments are tailored to the early and later postoperative periods. In the early period, which spans the first few weeks after surgery, both monitoring of anterior and posterior pituitary function and managing neurosurgical issues are the focus of care. Potential disruption of pituitary-adrenal function is covered wi… Show more

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Cited by 58 publications
(45 citation statements)
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References 51 publications
(109 reference statements)
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“…Therefore, it should be kept in mind that the cortisol level measured on the 2nd or 3rd postoperative day might not reflect, and may be higher than that at 1 week. Patients with cortisol levels lower than 220-270 nmol/l (8-10 mg/dl) on the 2nd or 3rd postoperative day are discharged and recommended for low-dose glucocorticoid replacement therapy (26)(27)(28)(29). The results of this study are consistent with these practices.…”
Section: Discussionsupporting
confidence: 77%
“…Therefore, it should be kept in mind that the cortisol level measured on the 2nd or 3rd postoperative day might not reflect, and may be higher than that at 1 week. Patients with cortisol levels lower than 220-270 nmol/l (8-10 mg/dl) on the 2nd or 3rd postoperative day are discharged and recommended for low-dose glucocorticoid replacement therapy (26)(27)(28)(29). The results of this study are consistent with these practices.…”
Section: Discussionsupporting
confidence: 77%
“…However, adrenal insufficiency secondary to the disruption of pituitary function is a wellrecognized complication of TSS. Therefore postoperative biochemical evaluation of the integrity of the hypothalamic-pituitary-adrenal (HPA) axis is imperative (2 ).…”
Section: © 2009 American Association For Clinical Chemistrymentioning
confidence: 99%
“…The use of ITT is also contraindicated in elderly patients and patients with cardiovascular disease or epilepsy (4 ). In light of its associated risks, performing ITT is not appropriate during the first few postoperative days, and most centers delay the ITT until 4 -6 weeks after TSS (2,6 ).…”
Section: © 2009 American Association For Clinical Chemistrymentioning
confidence: 99%
“…Available phone numbers are provided for use in emergency situations. Patient appointments for outpatient visits are arranged [6,13,22,23,26].…”
Section: Deficient Knowledgementioning
confidence: 99%
“…All medicines (hypoglycemic agents, diuretics, synthetic hormone replacement, etc.) that increase the risk of hyponatremia are checked, if necessary, intravenous sodium chloride solutions are administered according to the physician's order [6,13,[26][27][28].…”
Section: Risk For Electrolyte Imbalancementioning
confidence: 99%