Subfascial drains are safe and effective in preventing postoperative cerebrospinal fluid leaks after intradural spine tumor surgery.
Intentional durotomy
Intradural spinal tumors
Postoperative cerebrospinal fluid leak
Subfascial drains
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2024
2024
Historique:
received:
22
11
2023
accepted:
09
12
2023
medline:
12
2
2024
pubmed:
12
2
2024
entrez:
12
2
2024
Statut:
epublish
Résumé
Delayed cerebrospinal fluid (CSF) leaks are a known complication following intradural spinal tumor surgery. The placement of subfascial drains in these patients undergoing requisite intradural surgery is controversial. Here, we demonstrated that placing a subfascial drain on partial suction for 48 h, with early ambulation, proved to be safe and effective in preventing early/delayed recurrent CSF fistulas. Medical records of 17 patients undergoing surgery for intradural spinal tumors over a 30-month were reviewed. All patients underwent intradural tumor resection followed by primary dural closure, placement of Gelfoam in a non-compressive fashion, application of fibrin sealant, and utilization of a subfascial drain placed on partial suction for 48 h postoperatively. Patients are mobilized the morning following surgery. We tracked the incidence of postoperative recurrent CSF leaks, over drainage, infection, wound dehiscence, pseudo meningocele formation, and the reoperation rate. For the 17 patients, our programmed average utilization of subfascial drains was 48 h. Moreover, the average drain output was 165 mL. Over the 1-year follow-up period, no patient developed a recurrent early/ delayed CSF leak, there were no wound complications, nor need for revision surgery. Utilizing subfascial drains on partial suction following the resection of intradural spinal tumors with primary dural closure proved to be safe and effective.
Sections du résumé
Background
UNASSIGNED
Delayed cerebrospinal fluid (CSF) leaks are a known complication following intradural spinal tumor surgery. The placement of subfascial drains in these patients undergoing requisite intradural surgery is controversial. Here, we demonstrated that placing a subfascial drain on partial suction for 48 h, with early ambulation, proved to be safe and effective in preventing early/delayed recurrent CSF fistulas.
Methods
UNASSIGNED
Medical records of 17 patients undergoing surgery for intradural spinal tumors over a 30-month were reviewed. All patients underwent intradural tumor resection followed by primary dural closure, placement of Gelfoam in a non-compressive fashion, application of fibrin sealant, and utilization of a subfascial drain placed on partial suction for 48 h postoperatively. Patients are mobilized the morning following surgery. We tracked the incidence of postoperative recurrent CSF leaks, over drainage, infection, wound dehiscence, pseudo meningocele formation, and the reoperation rate.
Results
UNASSIGNED
For the 17 patients, our programmed average utilization of subfascial drains was 48 h. Moreover, the average drain output was 165 mL. Over the 1-year follow-up period, no patient developed a recurrent early/ delayed CSF leak, there were no wound complications, nor need for revision surgery.
Conclusion
UNASSIGNED
Utilizing subfascial drains on partial suction following the resection of intradural spinal tumors with primary dural closure proved to be safe and effective.
Identifiants
pubmed: 38344094
doi: 10.25259/SNI_934_2023
pii: 10.25259/SNI_934_2023
pmc: PMC10858779
doi:
Types de publication
Journal Article
Langues
eng
Pagination
8Informations de copyright
Copyright: © 2024 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest
Références
Neurosurgery. 1992 Feb;30(2):241-5
pubmed: 1545892
Front Surg. 2022 Sep 20;9:959533
pubmed: 36204341
World Neurosurg. 2012 Mar-Apr;77(3-4):564-8
pubmed: 22120372
Clin Neurol Neurosurg. 2018 Jul;170:61-66
pubmed: 29730270
Chin J Traumatol. 2016;19(1):35-8
pubmed: 27033271
Neurospine. 2018 Dec;15(4):338-347
pubmed: 30531655
J Neurosurg Spine. 2014 Aug;21(2):279-85
pubmed: 24867211
Global Spine J. 2016 Dec;6(8):780-785
pubmed: 27853662