Use of Active Low Suction Pressure (Subgaleal) Drains in Chronic Subdural Hematoma Surgery.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2024-12-06 DOI:10.1016/j.wneu.2024.11.040
Zakir H Chew, Tien M Cheong, Ji M Ling, Seyed E Saffari, Lester Lee
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Abstract

Background: Subdural drains are used to reduce recurrence after surgical evacuation of chronic subdural hematoma. There is a small risk of parenchymal injury. We hypothesize that using subgaleal drains with low active suction (-50 mm Hg to -100 mm Hg) may be a safer alternative and still maintain efficacy in preventing recurrence.

Methods: A retrospective review of adult patients who underwent surgical drainage of chronic subdural hematoma at our institution was performed. They were classified into 2 groups: a subdural group and a subgaleal group. We collected data on patient demographics, preoperative use of antiplatelets or anticoagulants, the type of drains used, laterality of burr-hole surgery performed and postoperative complications, and recurrence. Descriptive statistics and regression analyses were used to analyze the data.

Results: 322 patients recruited, 172 received subgaleal drains with low active suction and 150 received passive subdural drains. There was no significant difference in the rate of recurrence; there was 11. % recurrence in the subgaleal drain group and 9.3% recurrence in the subdural drain group (P = 0.660). Patients who underwent active subgaleal drain insertion had significantly fewer complications, at 2.3% compared with 8.0% in patients who had passive subdural drains (P = 0.037).

Conclusions: The use of subgaleal drains with low active suction led to significantly lower complication rates compared with the use of subdural drains and maintained its efficacy in preventing recurrence.

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在慢性硬膜下血肿手术中使用主动式低抽吸压力(气管下)引流管。
背景:硬膜下引流管用于减少慢性硬膜下血肿手术清除后的复发。实质损伤的风险较小。我们假设使用低主动抽吸量(-50mmHg 至 -100mmHg)的硬脑膜下引流管可能是一种更安全的替代方法,同时仍能保持防止复发的效果:方法: 我们对在本院接受慢性硬膜下血肿手术引流的成年患者进行了回顾性研究。这些患者被分为两组--硬膜下组和气囊下组。我们收集了患者的人口统计学数据、术前使用抗血小板或抗凝药物的情况、使用的引流管类型、所进行的毛细孔手术的侧向性以及术后并发症和复发情况。数据分析采用了描述性统计和回归分析:共招募了 322 名患者,其中 172 人接受了低主动抽吸的气囊下引流管,150 人接受了被动硬膜下引流管。复发率无明显差异,气囊下引流管组的复发率为 11.0%,硬膜下引流管组的复发率为 9.3%(P = 0.660)。主动插入硬膜下引流管的患者并发症明显较少,为2.3%,而被动插入硬膜下引流管的患者为8.0%(P = 0.037):结论:与使用硬膜下引流管相比,使用低主动抽吸的气囊下引流管可显著降低并发症发生率,同时还能有效预防复发。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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