Dergiler / Turkish Neurosurgery / 2019 / Cilt: 29 - Sayı: 3

Identification of Risk Factors for Postoperative Cerebrospinal Fluid Leakage and Comparison of Two Alternative Dural Augmentation Techniques in Posterior Fossa and Spinal Surgeries

Sayfa
377–385
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Non-tumoral pathologies, previoussurgery, and postoperative hydrocephalus appear to be independent risk factors for postoperative CSF leakage.

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Amaç & Hipotez:AIM: To investigate comparative efficacy of a novel absorbable adhesive membrane (TissuePatchDuralTM “TPD”) and a fibrin glue(Tisseel “T”) in reducing cerebrospinal fluid (CSF) leaks after posterior fossa and spinal procedures, and also to identify potentialrisk factors for CSF leakage.MATERIAL and METHODS: This is a single-center, retrospective cohort study of 123 consecutive posterior fossa (n=77) and spinal(n=46) surgeries.
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Temel Bulgular & Veri:Patients were grouped based on dural sealants used 2-group comparison: TPD (n=56) vs. no-TPD (n=67) and3-group comparison: T only (n=43), TPD only (n=32) vs TPD+T (n=35).RESULTS: Mean age was 38.9 ± 22.2 years (62 males, 61 females).
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Sonuç & Katkı:Non-tumoral pathologies, previoussurgery, and postoperative hydrocephalus appear to be independent risk factors for postoperative CSF leakage.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

AIM: To investigate comparative efficacy of a novel absorbable adhesive membrane (TissuePatchDuralTM “TPD”) and a fibrin glue(Tisseel “T”) in reducing cerebrospinal fluid (CSF) leaks after posterior fossa and spinal procedures, and also to identify potentialrisk factors for CSF leakage.MATERIAL and METHODS: This is a single-center, retrospective cohort study of 123 consecutive posterior fossa (n=77) and spinal(n=46) surgeries. Patients were grouped based on dural sealants used 2-group comparison: TPD (n=56) vs. no-TPD (n=67) and3-group comparison: T only (n=43), TPD only (n=32) vs TPD+T (n=35).RESULTS: Mean age was 38.9 ± 22.2 years (62 males, 61 females). Baseline characteristics were similar between groups. Neither2-group (TPD: 10.4% vs no-TPD: 8.9%; p=0.778) nor 3-group (T: 9.3% vs TPD: 6.3% vs TPD+T: 14.3%; p=0.539) comparisonsrevealed a significant difference in postoperative CSF leakage rates. Multivariate analysis showed that diagnosis (non-tumoral vs.tumor) (OR: 5.487; 95% CI: 1.118-26.937; p=0.036); previous surgery (OR: 9.268; 95% CI: 1.911-44.958; p=0.006), postoperativehydrocephalus (OR: 5.456; 95% CI: 1.250-23.821; p=0.024) were independent predictors of postoperative CSF leakage.CONCLUSION: TissuePatchDuralTM is a novel dural sealant patch which can be safely used to reinforce dural closure in posteriorfossa and spinal surgeries, and its efficacy is comparable to widely used fibrin glue (Tisseel). Non-tumoral pathologies, previoussurgery, and postoperative hydrocephalus appear to be independent risk factors for postoperative CSF leakage.

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Bu Makaleye Atıf Yap

ESER, M. T., HANALIOGLU, S., CETINER, M. Z., DINC, S., PEKER, H. O., SORAR, M., DOLGUN, H., TÜRKOĞLU, E. (2019). Identification of Risk Factors for Postoperative Cerebrospinal Fluid Leakage and Comparison of Two Alternative Dural Augmentation Techniques in Posterior Fossa and Spinal Surgeries. Turkish Neurosurgery, Cilt: 29 - Sayı: 3, 377–385. https://ajindex.com/articles/404387

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