Postoperative considerations following pituitary surgery: A guide for clinicians.

Transsphenoidal surgery represents primary treatment for pituitary adenomas (other than prolactin-secreting) and other sellar/suprasellar masses including craniopharyngiomas. Endocrine evaluation for anterior hypopituitarism and water metabolism disorders is indicated in all patients. Transient fluid restriction postoperatively in patients without vasopressin deficiency reduces the risk of hyponatremia and hospital readmission. In Cushing disease, postoperative serum cortisol levels in the first postoperative days guide further management. In acromegaly, remission is established primarily by IGF-1 measurement three months postoperatively. Patients with functioning adenomas require proactive management of comorbidities related to hormone excess and lifelong monitoring for recurrence. Surgical outcomes are superior at high-volume institutions with neurosurgical and endocrinological expertise.