Fibrin-coated collagen fleece versus absorbable dural sealant for sellar closure after transsphenoidal pituitary surgery: a comparative study.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
14 05 2022
Historique:
received: 02 09 2021
accepted: 02 05 2022
entrez: 14 5 2022
pubmed: 15 5 2022
medline: 18 5 2022
Statut: epublish

Résumé

Various surgical methods to prevent postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal surgery have been reported. However, comparative studies are scarce. We aimed to compare the efficacy of a fibrin-coated collagen fleece (TachoSil) versus a dural sealant (DuraSeal) to prevent postoperative CSF leakage. We perform a retrospective study comparing two methods of sellar closure during endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenoma resection: TachoSil patching versus DuraSeal packing. Data concerning diagnosis, reconstruction technique, and surgical outcomes were analyzed. The primary endpoint was postoperative CSF leak rate. We reviewed 198 consecutive patients who underwent 219 EETS for pituitary adenoma from February 2007 and July 2018. Intraoperative CSF leak occurred in 47 cases (21.5%). A total of 33 postoperative CSF leaks were observed (15.1%). A reduction of postoperative CSF leaks in the TachoSil application group compared to the conventional technique using Duraseal was observed (7.7% and 18.2%, respectively; p = 0.062; Pearson exact test) although non-statistically significant. Two patients required lumbar drainage, and no revision repair was necessary to treat postoperative CSF rhinorrhea in Tachosil group. Fibrin-coated collagen fleece patching may be a valuable method to prevent postoperative cerebrospinal fluid (CSF) leaks during EETS for pituitary adenoma resection.

Identifiants

pubmed: 35568737
doi: 10.1038/s41598-022-12059-x
pii: 10.1038/s41598-022-12059-x
pmc: PMC9107464
doi:

Substances chimiques

Fibrin 9001-31-4
Collagen 9007-34-5

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

7998

Informations de copyright

© 2022. The Author(s).

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Auteurs

Julien Spitaels (J)

Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070, Bruxelles, Belgium. julien.spitaels@erasme.ulb.ac.be.

Justin Moore (J)

Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Nathalie Zaidman (N)

Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Isabel Fernandes Arroteia (IF)

Department of Neurosurgery, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg.

Geoffrey Appelboom (G)

Department of Neurosurgery, St. Joseph's University Medical Center, Paterson, NJ, USA.

Sami Barrit (S)

Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070, Bruxelles, Belgium.

Sébastien Carlot (S)

Department of Otorhinolaryngology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.

Viviane De Maertelaer (V)

Institute of Interdisciplinary Research (IRIBHM), Université Libre de Bruxelles, Brussels, Belgium.

Sergio Hassid (S)

Department of Otorhinolaryngology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.

Olivier De Witte (O)

Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070, Bruxelles, Belgium.

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