Is peri-operative steroid replacement therapy necessary for the pituitary adenomas treated with surgery? A systematic review and meta analysis

PloS One
Mamatemin TohtiChiyuan Ma

Abstract

Patients with pituitary adenomas usually receive "stress dose" steroids in the peri-operative peroids. Though randomized controlled trials(RCT) have not been performed to assess the necessity of steroid coverage, there are several studies that explained the changes of adrenal function during peri-operative peroids. The aim of the present study is to investigate whether it is necessary to employ conventional peri-operative glucocorticoid replacement therapy to all the patients undergoing surgery. We searched studies addressing peri-operative steroids coverage for pituitary adenomas in the Web of Science, Medline and the Cochrane Library. Then we extracted studies about peri-operative morning serum cortisol(MSC) levels, morbidity of early postoperative adrenal insufficiency, postoperative diabetes insipidus, relationships between MSC levels and adrenal integrity. We used RevMan Software to combine the results for meta-analysis. We used fixed-effects models for there was no significant heterogeneity existed. There are 18 studies from 11 countries published between 1987 and 2013 including 1224 patients. The postoperative serum cortisol levels were significantly increased compared with the preoperative one in hypothalamic-pituitary-...Continue Reading

References

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Citations

Apr 29, 2016·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Xiaolin JiaLaurence Katznelson
Jul 28, 2019·Pathology Oncology Research : POR·Rafał StecAleksandra Semeniuk-Wojtaś
Sep 19, 2019·Surgical Neurology International·Nathan C PecoraroAnand V Germanwala
Nov 5, 2016·The Journal of Clinical Endocrinology and Metabolism·Maria FleseriuMary H Samuels
May 9, 2019·Acta neurochirurgica·Ola Fridman-BengtssonOla Sunnergren
May 16, 2019·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·Tanja Skoric PolovinaDarko Kastelan

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Software Mentioned

Revman

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