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Rapid closure technique in suboccipital decompression

OBJECTIVE: Suboccipital decompression has been established as standard therapeutic procedure for raised intracranial pressure caused by mass-effect associated pathologies in posterior fossa. Several different surgical techniques of dural closure have been postulated to achieve safe decompression. Th...

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Autores principales: Vychopen, Martin, Hadjiathanasiou, Alexis, Brandecker, Simon, Borger, Valeri, Schuss, Patrick, Vatter, Hartmut, Güresir, Erdem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192370/
https://www.ncbi.nlm.nih.gov/pubmed/34562136
http://dx.doi.org/10.1007/s00068-021-01779-w
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author Vychopen, Martin
Hadjiathanasiou, Alexis
Brandecker, Simon
Borger, Valeri
Schuss, Patrick
Vatter, Hartmut
Güresir, Erdem
author_facet Vychopen, Martin
Hadjiathanasiou, Alexis
Brandecker, Simon
Borger, Valeri
Schuss, Patrick
Vatter, Hartmut
Güresir, Erdem
author_sort Vychopen, Martin
collection PubMed
description OBJECTIVE: Suboccipital decompression has been established as standard therapeutic procedure for raised intracranial pressure caused by mass-effect associated pathologies in posterior fossa. Several different surgical techniques of dural closure have been postulated to achieve safe decompression. The aim of this study was to examine the differences between fibrin sealant patch (FSP) and dural reconstruction (DR) in suboccipital decompression for acute mass-effect lesions. METHODS: We retrospectively analyzed our institutional data of patients who underwent suboccipital decompression due to spontaneous intracerebellar hemorrhage, cerebellar infarction and acute traumatic subdural hematoma between 2010 and 2019. Two different dural reconstruction techniques were performed according to the attending neurosurgeon: (1) fibrin sealant patch (FSP), and (2) dural reconstruction (DR) including the use of dural patch. Complications, operative time, functional outcome and the necessity of a ventriculoperitoneal shunt (VP Shunt) were assessed and further analyzed. RESULTS: Overall, 87 patients were treated at the authors’ institution (44 in FSP group, 43 in DR group). Glasgow coma scale on admission and preoperative coagulation state did not differ between the groups. Postoperatively, we found no difference in cerebrospinal fluid leakage or chronic hydrocephalus between the groups (p = 0.47). Revision rates were 2.27% (1/44 patients) in the FSP group, compared to 16.27% (7/43) in the DR group (p < 0.023). Operative time was significantly shorter in the FSP group (90.3 ± 31.0 min vs. 199.0 ± 48.8 min, p < 0.0001). CONCLUSION: Rapid closure technique in suboccipital decompression is feasible and safe. Operative time is hereby reduced, without increasing complication rates.
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spelling pubmed-91923702022-06-15 Rapid closure technique in suboccipital decompression Vychopen, Martin Hadjiathanasiou, Alexis Brandecker, Simon Borger, Valeri Schuss, Patrick Vatter, Hartmut Güresir, Erdem Eur J Trauma Emerg Surg Original Article OBJECTIVE: Suboccipital decompression has been established as standard therapeutic procedure for raised intracranial pressure caused by mass-effect associated pathologies in posterior fossa. Several different surgical techniques of dural closure have been postulated to achieve safe decompression. The aim of this study was to examine the differences between fibrin sealant patch (FSP) and dural reconstruction (DR) in suboccipital decompression for acute mass-effect lesions. METHODS: We retrospectively analyzed our institutional data of patients who underwent suboccipital decompression due to spontaneous intracerebellar hemorrhage, cerebellar infarction and acute traumatic subdural hematoma between 2010 and 2019. Two different dural reconstruction techniques were performed according to the attending neurosurgeon: (1) fibrin sealant patch (FSP), and (2) dural reconstruction (DR) including the use of dural patch. Complications, operative time, functional outcome and the necessity of a ventriculoperitoneal shunt (VP Shunt) were assessed and further analyzed. RESULTS: Overall, 87 patients were treated at the authors’ institution (44 in FSP group, 43 in DR group). Glasgow coma scale on admission and preoperative coagulation state did not differ between the groups. Postoperatively, we found no difference in cerebrospinal fluid leakage or chronic hydrocephalus between the groups (p = 0.47). Revision rates were 2.27% (1/44 patients) in the FSP group, compared to 16.27% (7/43) in the DR group (p < 0.023). Operative time was significantly shorter in the FSP group (90.3 ± 31.0 min vs. 199.0 ± 48.8 min, p < 0.0001). CONCLUSION: Rapid closure technique in suboccipital decompression is feasible and safe. Operative time is hereby reduced, without increasing complication rates. Springer Berlin Heidelberg 2021-09-25 2022 /pmc/articles/PMC9192370/ /pubmed/34562136 http://dx.doi.org/10.1007/s00068-021-01779-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Vychopen, Martin
Hadjiathanasiou, Alexis
Brandecker, Simon
Borger, Valeri
Schuss, Patrick
Vatter, Hartmut
Güresir, Erdem
Rapid closure technique in suboccipital decompression
title Rapid closure technique in suboccipital decompression
title_full Rapid closure technique in suboccipital decompression
title_fullStr Rapid closure technique in suboccipital decompression
title_full_unstemmed Rapid closure technique in suboccipital decompression
title_short Rapid closure technique in suboccipital decompression
title_sort rapid closure technique in suboccipital decompression
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192370/
https://www.ncbi.nlm.nih.gov/pubmed/34562136
http://dx.doi.org/10.1007/s00068-021-01779-w
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