[Value of basal cortisol and ACTH in the immediate postoperative period of hypophyseal surgery in non-ACTH secretory adenomas].
BACKGROUND
The aim of this study was to evaluate the usefulness of basal cortisol and ACTH in the immediate postoperative period of pituitary surgery as indicators of definitive adrenocorticotropin function.


METHODS
Twenty-one patients with pituitary, non producers of ACTH, adenomas, three microadenomas and 18 macroadenomas treated by adenomectomy by a trans-sphenoidal route were respectively studied. The basal cortisol and ACTH were compared in the first week following surgery with the definitive results obtained after one month by dynamic tests (stimulation with ACTH or insulin hypoglycemia).


RESULTS
The six patients with secondary adrenal failure (AF) in the definitive evaluation had lower basal cortisol in the immediate postoperative period than the patients with AF (135.3 +/- 225.3 nmol/l versus 473.6 +/- 147.2 nmol/l; p < 0.05). The values of ACTH were also lower (2.3 +/- 1.6 nmol/l versus 4.8 +/- 3.4; p < 0.05). In all the patients with definitive AF except one, the basal cortisol in the first week was lower than 130 nmol/l and in those who did not present AF it was greater than 220 nmol/l.


CONCLUSIONS
In the immediate postoperative period after pituitary surgery cortisol is a good indicator of definitive adrenocorticotropin function. This parameter may identify the patients requiring posterior substitutive treatment.
Camps
I
I
Servicio de Endocrinología, Ciutat Sanitària i Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona.
Gómez
J M
JM
Bonnin
R
R
Montaña
E
E
Acebes
J
J
Soler
J
J
D000236:Adenoma / Q000097:blood* / Q000601:surgery*; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood* / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
Interés del cortisol y de la ACTH basales en el postoperatorio inmediato de cirugía hipofisaria en adenomas no secretores de ACTH.