Pituitary Adenoma Clinical Trial
Official title:
The Use of Perioperative Steroids in Patients Undergoing Transsphenoidal Resection of Pituitary Tumors or Cysts
During transsphenoidal resection of pituitary tumors and cysts, surgery is performed by a
neurosurgeon and ear nose and throat surgeon. The pituitary tumor or cyst is reached by
making a small hole in the back of the nose into the bottom of the skull. The surgeon is able
to see the pituitary and tumor with an endoscope and remove the tumor through the hole.
Surgery on the pituitary can cause disruption in the secretion of ACTH and cause adrenal
failure (lack of cortisol secretion) which can cause nausea, vomiting, low blood pressure,
and rarely can be fatal. There is no consensus among endocrinologists and neurosurgeons about
the use of perioperative steroids in pituitary patients. Traditionally, all patients
undergoing pituitary surgery were given steroids before, during, and after surgery because of
the assumption that there would be some compromise in the amount of ACTH released by the
pituitary as a result of surgical trauma. Studies have failed to show, however, that ACTH
secretion is in fact compromised during transsphenoidal pituitary microsurgery. As a result,
there are some centers that routinely give perioperative steroids to all patients undergoing
pituitary surgery and there are some centers that do not routinely give perioperative
steroids. There are several retrospective and prospective studies that have addressed this
issue and have shown that withholding perioperative steroids is safe, but there has never
been a prospective study comparing the two approaches.
Objectives: The goal of this study is to prospectively compare two approaches to the
perioperative management of patients undergoing transsphenoidal resection of a pituitary
tumor or cyst. One protocol includes the routine use of perioperative steroids and the other
does not. The investigators hypothesis, based on previous studies, is that patients who are
adrenally sufficient do not routinely need to be treated with perioperative steroids. The
investigators also hypothesize that the use of perioperative steroids may be associated with
a higher rate of adverse outcomes
Patients who are scheduled to undergo transsphenoidal resection for a pituitary tumor or cyst at the investigators institution will be screened prior to surgery for eligibility for this study. All patients deemed eligible will undergo a cosyntropin stimulation test to evaluate for adrenal insufficiency. Patients with adrenal insufficiency will be excluded from the study. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04081701 -
68-Ga DOTATATE PET/MRI in the Diagnosis and Management of Somatostatin Receptor Positive CNS Tumors.
|
Phase 4 | |
Completed |
NCT01689064 -
Comparison of Surgical Approach to Endoscopic Pituitary Adenoma Resection
|
N/A | |
Recruiting |
NCT04611685 -
Pain Management After Transnasal Transsphenoidal Surgery for Pituitary Adenomas
|
N/A | |
Completed |
NCT04212793 -
Detection of PitNET Tissue During TSS Using Bevacizumab-800CW
|
Phase 1 | |
Recruiting |
NCT02709863 -
Comparison of The Effects of Sevoflurane, Desflurane and Total Intravenous Anaesthesia on Pulmonary Function Tests
|
N/A | |
Completed |
NCT01465672 -
Copeptin as a Diagnostic Marker in the Management of Neurosurgical Patients With Disturbance of Water Homeostasis
|
N/A | |
Terminated |
NCT00798057 -
Proton Radiation Therapy for Pituitary Adenoma
|
N/A | |
Completed |
NCT01504399 -
Rhinological Outcomes in Endonasal Pituitary Surgery
|
||
Recruiting |
NCT01556230 -
Prospective Study of Clinically Nonfunctioning Pituitary Adenomas
|
||
Completed |
NCT04074642 -
OCT-angiography as a Pronostic Marker for Visual Impairment in Patients Undergoing Neurosurgery for Compressive Macroadenoma : a Prospective Study.
|
N/A | |
Recruiting |
NCT04621565 -
Hydrocortisone Use During Peri-operation for Pituitary Adenomas
|
N/A | |
Completed |
NCT04076046 -
Multicentric Prospective Validation of the Zurich Pituitary Score
|
||
Not yet recruiting |
NCT03714763 -
Dopamine D2 Receptors(D2R) Imaging in Nonfunctioning Pituitary Adenoma(NFPA)
|
N/A | |
Recruiting |
NCT05822817 -
Comparison of Postoperative Recovery of Sevoflurane and Propofol After Transsphenoidal Surgery
|
Phase 4 | |
Recruiting |
NCT03164148 -
Heart Rate Variability (HRV) in Pituitary Adenoma
|
N/A | |
Completed |
NCT04284605 -
Effects Exercise Training in Patients With Pituitary Adenoma
|
N/A | |
Terminated |
NCT03515603 -
Endocrine Outcome of Surgery for Pituitary Adenoma
|
N/A | |
Not yet recruiting |
NCT04863456 -
Efficiency and Safety of Different Treatment Strategies in Adults With Pituitary Adenomas With Hypothalamic Involvement
|
N/A | |
Active, not recruiting |
NCT03465618 -
A First in Human Study Using 89Zr-cRGDY Ultrasmall Silica Particle Tracers for Malignant Brain Tumors
|
Phase 1 | |
Completed |
NCT02727686 -
Post-Operative Water Load Following Transsphenoidal Pituitary Surgery
|
N/A |