Early Morning Cortisol Levels as Predictors of Short- and Long-Term Adrenal Function after Endonasal Transsphenoidal Surgery for Pituitary Adenomas and Rathke's Cleft Cysts

Abstract

Introduction: Patients undergoing pituitary adenoma or Rathke's cleft cyst (RCC) removal are often administered perioperative glucocorticoids regardless of lesion size and preoperative ACTH/cortisol levels. To minimize unnecessary glucocorticoid therapy, we describe a protocol in which patients with normal preoperative serum cortisol and ACTH levels are given glucocorticoids only if postoperative day 1 or 2 (POD1 or POD2) cortisol levels fall below normal.