Observational studyActa neurochirurgica2019
Evaluation of different hydrocortisone treatment strategies in transsphenoidal pituitary surgery.
Observational study in Acta neurochirurgica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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.
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Who cites it
4 citing papers in PubMed.
- Perioperative Complications Associated with Routine Preoperative Glucocorticoid Use Among Patients Undergoing Pituitary Surgery with Normal Preoperative HPA Axis: A Retrospective Cohort Study.Journal of the ASEAN Federation of Endocrine Societies · 2025Article
- Remission, complications, and overall survival in transsphenoidal pituitary surgery-a Swedish single-center experience of 578 patients.Acta neurochirurgica · 2023Article
- Endocrinological aspects of pituitary adenoma surgery in Europe.Scientific reports · 2022Article
- Investigation of the Hypothalamo-pituitary-adrenal (HPA) axis: a contemporary synthesis.Reviews in endocrine & metabolic disorders · 2021Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHydrocortisone treatment in transsphenoidal pituitary surgery has been debated. Although several publications advocate restrictive treatment, centers around the world administer stress doses of hydrocortisone in patients with presumed intact cortisol production. Our aim with this analysis was to compare postoperative hypocortisolism in patients who received three different protocols of hydrocortisone therapy during and after surgery.
methodThis was a retrospective observational study. Based on perioperative hydrocortisone dose given, patients were divided in three groups: high dose (HD), intermediate dose (ID), and low dose (LD). Postoperative evaluation of the pituitary function was performed using S-cortisol at day 4 and short Synacthen test (SST) at 6-8 weeks. Patients with ACTH-producing adenomas or preoperative hydrocortisone treatment were excluded.
resultThere was no difference between the groups regarding failure rate of SST. The rate of failed SST (all groups) was 51/186 (27%), 24/74 (32%) in the HD group and 26/74 (35%) and 11/38 (29%) in the ID and LD groups respectively. There was no significant difference between the ID and LD groups regarding S-cortisol at postoperative day 4 regarding serum cortisol level below 200 nmol/L. There was a significant but weak correlation, r
conclusionsPeri and postoperative hydrocortisone treatment did not affect SST response 6-8 weeks postoperatively, whereas the rate of patients with S-cortisol below 200 nmol/L at postoperative day 4 did. LD hydrocortisone therapy seems to favor a better endogenous production in the early postoperative phase.
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