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The incidence of postoperative cerebrospinal fluid leakage after elective cranial surgery: a systematic review
Neurosurgical Review ( IF 2.8 ) Pub Date : 2021-09-09 , DOI: 10.1007/s10143-021-01641-y
Birgit Coucke 1, 2 , Laura Van Gerven 2, 3, 4 , Steven De Vleeschouwer 1, 5 , Frank Van Calenbergh 1, 5 , Johannes van Loon 1, 5 , Tom Theys 1, 5
Affiliation  

Cerebrospinal fluid (CSF) leakage is a major complication after elective neurosurgical procedures. The aim of this systematic literature review is to summarize the incidence rates of postoperative cerebrospinal fluid leakage for neurosurgical procedures, classified by surgical approach. The Pubmed, Cochrane, Embase, and Web of Science databases were searched for studies reporting the outcome of patients undergoing elective neurosurgical procedures. The number of patients, surgical approach, and indication for surgery were recorded for each study. Outcomes related to CSF leakage such as clinical manifestation and treatment were reported as well. One hundred and thirteen studies were included, reporting 94,695 cases. Overall, CSF leaks were present in 3.8% of cases. Skull base surgery had the highest rate of CSF leakage with 6.2%. CSF leakage occurred in 5.9% of anterior skull base procedures, 6.4% of middle fossa, and 5.2% of transpetrosal surgeries. 5.8% of reported infratentorial procedures were complicated by CSF leakage versus 2.9% of supratentorial surgeries. CSF leakage remains a common serious adverse event after cranial surgery. There exists a need for standardized procedures to reduce the incidence of postoperative CSF leakage, as this serious adverse event may lead to increased health care costs.



中文翻译:

择期颅脑手术后脑脊液漏发生率的系统评价

脑脊液 (CSF) 渗漏是择期神经外科手术后的主要并发症。本系统文献综述的目的是总结神经外科手术术后脑脊液漏的发生率,按手术方式分类。在 Pubmed、Cochrane、Embase 和 Web of Science 数据库中搜索了报告患者接受选择性神经外科手术结果的研究。记录每项研究的患者人数、手术方法和手术指征。还报告了与 CSF 渗漏相关的结果,例如临床表现和治疗。纳入了 113 项研究,报告了 94,695 例病例。总体而言,3.8% 的病例出现脑脊液漏。颅底手术的脑脊液漏率最高,为 6.2%。脑脊液漏发生在 5.9% 的前颅底手术、6.4% 的中颅窝和 5.2% 的经颅骨手术中。5.8% 的幕下手术因脑脊液漏而复杂化,而幕上手术的这一比例为 2.9%。脑脊液漏仍然是颅脑手术后常见的严重不良事件。需要标准化程序来减少术后脑脊液泄漏的发生率,因为这种严重的不良事件可能导致医疗保健成本增加。

更新日期:2021-09-10
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