Evidence-based management strategies for endocrine complications after pituitary adenoma surgery

This study aims to provide a clinical reference for the management of endocrine complications in pituitary tumor patients by synthesizing recent evidence for domestic and international management strategies. Based on the PIPOST (Population, Intervention, Professional, Outcome, Setting, and Type of Evidence) framework, evidence-based medicine targets were determined. Electronic decision support systems, guideline websites, and databases were searched to identify the best evidence on postoperative endocrine complications in pituitary tumors. The PICO (Patient, Intervention, Comparison, Outcome) principle was used to construct the search strategy, and the studies from the past 10 years (July 2013 to July 2023) were included. A total of 11 articles were included, including four guidelines, two expert consensus statements, one systematic review, one best practice article, and three randomized controlled trials. We obtained evidence on five aspects (endocrine assessment, secondary adrenal insufficiency management, water metabolism disorder management, special population management, and follow-up management) with a total of 30 pieces of evidence. Clinical healthcare professionals should focus on the care and follow-up of patients with postoperative complications, such as adrenal insufficiency, temporary or permanent diabetes insipidus, and hyponatremia. Future research should involve large sample sizes, long-term follow-ups, and multicenter studies to further clarify the protocols for fluid restriction, diet, and hormone use.