Pituitary tumors pose a formidable challenge due to the close proximity to the hypothalamus. They are often operated using endoscopic techniques. The first week after surgery is a critical phase due to a severe disturbance in thirst and water balance in the body, resulting in diabetes insipidus. This causes increased urine output, higher levels of sodium in the blood, and more significant morbidity.
The PGIMER team of Ms. Hemlata, Dr. Manju, and others, led by Dr. Dhandapani SS, designed and reported on the first-ever dietary bundle to prevent severe fluctuations in water and sodium levels in the body following pituitary surgery. This is published in “Journal of Advanced Nursing,” the most cited and top international nursing journal, with an impact factor of 2.6.
Their protocol focuses on taking only water during thirst and avoiding added salt, high-protein foods, and caffeinated drinks. In a randomized controlled trial, they showed that dietary counseling of this protocol after surgery resulted in significant benefits concerning urine output, sodium abnormalities, medication requirement, and hospital stay. This will make postoperative management less cumbersome, as its implementation is simple and easy to carry out. This will be a boon in resource-constrained institutions, where continuous monitoring and repeated serum sodium estimation are complex.
Dr. Dhandapani’s team has also previously been the first in the world to remove a large brain tumor through the nose of a 16-month toddler a few months back. They have also previously reported many minimally invasive endoscopic approaches in spine and brain surgery in several reputed journals.