Prevention of Hyponatremia After Transsphenoidal Surgery: A Systematic Review

[摘要] Context: Pituitary adenomas are amongst the most common tumors with a low mortality rate compared to other intracranialmalignancies. Delayed hyponatremia (DH) is a common finding after transsphenoidal resection (TSS), which is the basis for themanagement of these tumors. Although DH is one of the leading causes of readmission after TSS, no unified guidelines exist withregard to the prevention of this electrolyte disturbance.Objectives: This study aims to evaluate and compare existing preventive protocols for DH in order to identify and signify theircommon grounds.Methods: After a search in electronic databases, including PubMed (NCBI), Embase, Scopus, and Google Scholar with the keywordsof “pituitary adenoma,” “hyponatremia,” “transsphenoid surgery”, “water electrolyte balance,” “patient readmission", six originalarticles were included in the study.Results: We found that a protocol that both identifies groups susceptible to DH (males, older individuals, and those with a lowerBMI) and consists of fluid restriction, sodium supplementation, and regular serum sodium monitoring could be utilized to preventDH in patients with pituitary adenomas after TSS.Conclusions: Further studies with a larger sample size must be conducted to compare existing protocols for preventing DH andalso investigate post-surgery optimal fluid-restricted diets and corticosteroid therapy in these patients.

[学科分类] 基础医学

[关键词] Delayed Hyponatremia;Pituitary Adenoma;Fluid Restriction;Transsphenoidal Surgery