Vaccum drainage system application in the management of operation-related non-regional epidural hematoma.

Annals of surgical innovation and research Pub Date : 2013-07-10 eCollection Date: 2013-01-01 DOI:10.1186/1750-1164-7-7
Jun Ma, Huan Li, Linggang Cheng, Song Lin
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Abstract

Background: Epidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique.

Methods: Seven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system.

Results: The vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed.

Conclusions: Compared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis.

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真空引流系统在手术相关非区域硬膜外血肿治疗中的应用。
背景:硬膜外颅内血肿是颅内肿瘤手术最常见的并发症之一。非区域硬膜外血肿与术中颅内压剧烈波动有关。传统的开颅血肿引流方法耗时长,且可能加重颅内压失衡,造成并发症。我们设计了一种采用真空硬膜外引流系统的方法,并尝试评价这种新技术的优缺点。方法:选取7例颅内肿瘤患者。所有患者均行肿瘤切除术,术中超声或CT扫描证实术中非区域性硬膜外血肿。采用真空排水系统。选择10例行开颅术进行术中非区域硬膜外血肿清除的患者作为对照。之后进行常规测试,如连续CT扫描,以评估有效性,并帮助决定何时拆除引流系统。结果:真空引流术能有效清除个体化血肿,防止复发性硬膜外出血。排水系统在4天内被拆除。所有病人都恢复得很好。未见与引流系统相关的并发症。结论:与传统开颅术相比,采用真空硬膜外引流系统处理硬膜外血肿的新方法清除血肿效果相同,且创伤小,操作简单,并发症少,住院时间短,经济负担轻,预后好。
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