Postoperative Diagnostik und Substitutionstherapie bei Hypophysentumoren

Abstract

1. Perioperatively, patients with pituitary tumors should regularity receive Cortisol therapy, since it is difficult to predict exactly postoperative secondary adrenal insufficiency. Postoperative diabetes insipidus is instable and should be substituted carefully with fluid and antidiuretic hormone. 2. Follow-up studies of 19 patients with acromegaly and of 42 patients with pituitary tumors — chromophobe adenoma (N = 19), mixed type adenoma (N = 13) and eranio-pharyngeoma (N = 10) — were performed. Postoperatively, among the latter 42 patients, secondary hypogonadism (75%) was more frequently found than secondary adrenal insufficiency (65%) and secondary hypothyroidism (51%). 3. Long-term substitutive therapy of postoperative pituitary insufficiency has to follow careful diagnostic measures and must be controled in regular intervals. Any patient with pituitary tumor should postoperatively be provided with a certification warning of the danger of acute pituitary insufficiency in cases of accidents or acute illness.