Dural suturing for the resolution of high-flow cerebrospinal fluid leakage after extended endoscopic endonasal approach surgery.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Hongpeng Guan, Qi Song, Shiting Li, Xuhui Wang
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Abstract

High-flow cerebrospinal fluid (CSF) leakage is a major complication after surgery via the extended endoscopic endonasal approach (EEA). Thus, surgeons are still searching for techniques to avoid postoperative cerebrospinal fluid (poCSF) leakage. Recently, several surgeons have attempted dural suturing to prevent poCSF leakage. This study was performed to evaluate the efficacy of dural suturing for preventing poCSF leakage and presents a description of our operative technique. A total of 167 patients who underwent surgery via the extended EEA were enrolled in this study from January 2020 to May 2024. Among them, 75 patients underwent multilayered reconstruction only before May 2022. 92 patients underwent multilayered reconstruction combined with dural suturing after May 2022. The clinical data of the dural suturing group were compared with those of the no dural suturing group. All surgeries were performed by an experienced endoscopic neurosurgical team. Eighteen of 75 (24.0%) patients in the no dural suturing group and 2 of 92 patients (2.2%) in the dural suturing group developed poCSF leakage (p < 0.001). This finding indicates that dural suturing helps prevent poCSF leakage after lesion resection via the extended EEA.

硬脑膜缝合解决扩大内镜鼻内入路手术后高流量脑脊液漏。
大流量脑脊液(CSF)渗漏是经扩大内镜鼻内入路(EEA)手术后的主要并发症。因此,外科医生仍在寻找避免术后脑脊液(poCSF)泄漏的技术。最近,一些外科医生尝试硬脑膜缝合来防止poCSF渗漏。本研究旨在评估硬脑膜缝合预防poCSF渗漏的效果,并介绍我们的手术技术。从2020年1月到2024年5月,共有167名通过延长的EEA接受手术的患者参加了这项研究。其中75例患者仅在2022年5月前进行了多层重建。2022年5月后行多层重建联合硬膜缝合92例。将硬脊膜缝合组与未硬脊膜缝合组的临床资料进行比较。所有手术均由经验丰富的内窥镜神经外科团队进行。无硬脊膜缝合组75例患者中有18例(24.0%)出现poCSF渗漏,92例患者中有2例(2.2%)出现poCSF渗漏(p
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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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