Transsphenoidal surgery represents the primary treatment for pituitary adenomas (other than prolactin-secreting) and other sellar/suprasellar masses including craniopharyngiomas. Endocrine evaluation for anterior hypopituitarism and water metabolism disorders is indicated in all patients. Transient fluid restriction postoperatively in patients without vasopressin deficiency reduces the risk of hyponatremia and hospital readmission. In Cushing disease, the postoperative serum cortisol levels in the first postoperative days guide further management. In acromegaly, remission is established primarily by insulin-like growth factor-1 measurement 3 months postoperatively. Patients with functioning adenomas require proactive management of comorbidities related to hormone excess and lifelong monitoring for recurrence. Surgical outcomes are superior at high-volume institutions with neurosurgical and endocrinological expertise.

transsphenoidal surgery

postoperative management

remission

recurrence

vasopressin deficiency

syndrome of inappropriate antidiuresis

American Association of Clinical Endocrinology

adrenocorticotropic hormone

anterior pituitary hormone deficit

arginine vasopressin deficiency

cavernous sinus invasion

growth hormone deficiency

glucocorticoid withdrawal syndrome

hypothalamic-pituitary-adrenal

insulin-like growth factor-1

magnetic resonance imaging

syndrome of inappropriate antidiuresis

transsphenoidal surgery

venous thromboembolism

© 2025 AACE. Published by Elsevier Inc.