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Exp Clin Endocrinol Diabetes 2019; 127(01): 29-36
DOI: 10.1055/a-0664-7710
Article
© Georg Thieme Verlag KG Stuttgart · New York

Consensus on Postoperative Recommendations After Transsphenoidal Surgery

A Study Among Pituitary Surgeons in Germany and Review of Literature
Ulrich J. Knappe
1   Department of Neurosurgery, Johannes Wesling Klinikum, University Hospital of Ruhruniversität Bochum, Minden
,
Dag Moskopp
2   Department of Neurosurgery, Vivantes Klinikum Friedrichshain, Berlin
,
Rüdiger Gerlach
3   Department of Neurosurgery, Helios Kliniken, Erfurt
,
Jens Conrad
4   Department of Neurosurgery, Johannes Gutenberg Universität, Mainz
,
Jörg Flitsch
5   Department of Neurosurgery, Universitätskrankenhaus Eppendorf, Hamburg
,
Jürgen B. Honegger   *
6   Department of Neurosurgery, Universitätsklinikum Tübingen, Germany
› Author Affiliations
Further Information

Publication History

received 16 May 2018
revised 15 July 2018

accepted 26 July 2018

Publication Date:
21 August 2018 (online)

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Abstract

Background Guidelines for patient behavior following transsphenoidal surgery do not exist. To gain generally recommendations, the German pituitary working group conducted a study among pituitary surgeons to elucidate their opinions and customs of patients’ counselling.

Methods Questions concerning daily activities, exertion of sports and work life were addressed. It was asked to provide the postoperative time interval after which specific activities can be resumed both after a routine or an extended approach.

Results Fourteen pituitary surgeons returned the completed questionnaire. Following routine operations, washing the hair was allowed within one week, blowing the nose after 3, flying on an airplane and driving a car after one, lifting heavy weights after 4, playing wind instruments after 6, use of CPAP (continuous positive airway pressure) device after 3, permit leisure sports after 2 to 4 weeks (except for scuba diving). Competitive sports can be resumed after 6 weeks. Occupation with mental demands was considered feasible after 2 weeks, with physical labor after 4 weeks. After extended transsphenoidal surgery, the recommended time interval was roughly twice as long compared to the routine approach. Driving a car was allowed within the first 4 weeks after surgery by some pituitary surgeons, while others allow driving only after 3 months analogous to the regulations after craniotomy. The risk of scuba diving was considered high.

Conclusions The data of our study and the literature, and expert opinions from related scientific fields resulted in a consensus on recommendations for patients’ conduct to minimize risks after transsphenoidal surgery.

Key words

pituitary tumor - transsphenoidal surgery - postoperative recommendations

* Speaker of the Pituitary Study Group, German Society of Endocrinology (DGE)


Supplementary Material

    AGREE Reporting Checklist 2016 Online content viewable at https://doi.org/10.1055/a-0664-7710
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