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Simultaneous or staged operation? Timing of cranioplasty and ventriculoperitoneal shunt after decompressive craniectomy
期刊文章

Simultaneous or staged operation? Timing of cranioplasty and ventriculoperitoneal shunt after decompressive craniectomy

H.-Y. Lin, K.-C. Lin, C.-C. Tsai 和 D. Wan
Formosan Journal of Surgery, 卷.52(4), 頁碼.122-126
2019

摘要

Cranioplasty decompressive craniectomy ventriculoperitoneal shunt antibiotic agent adult aged antibiotic therapy Article brain infarction brain ventricle peritoneum shunt central nervous system infection cohort analysis controlled study cranioplasty data analysis software decompressive craniectomy demography epidural hemorrhage female human major clinical study male medical record review postoperative complication postoperative hemorrhage postoperative infection priority journal reoperation retrospective study skin infection subarachnoid hemorrhage subdural hematoma traumatic brain injury
Aims: Cranioplasty and ventriculoperitoneal shunt (VPS) are common procedures for patients who undergo decompressive craniectomy. The ideal time for these two procedures remains controversial. Settings and Design: This is a retrospective, single institute, chart review comparing the complications associated with simultaneous and staged cranioplasty and VPS. Materials and Methods: From January 2012 to December 2017, 56 patients who underwent both cranioplasty and VPS surgery at our hospital were separated into simultaneous or staged operation groups. We compared the demographic data and complications, including infections, subdural or epidural hemorrhage, and revision surgery between the groups. Statistical Analysis Used: Independent Student's t-test was used for analysis of continuous variables, and Fisher's exact test was used for categorical data. MedCalc (version: 18.11) was used to perform all analysis. Results: Nineteen patients underwent simultaneous cranioplasty and VPS, whereas 37 underwent staged operation. Etiologies for craniectomy included traumatic brain injury, infarction, spontaneous subarachnoid hemorrhage, and spontaneous intracerebral hemorrhage. There were no significant differences in the baseline characteristics between the groups. The overall complication rate was 14.3%. Three (15.8%) patients experienced complications in the simultaneous group: One (5.3%) with skin infection and two (10.5%) with overdrainage. Five (13.5%) patients experienced complications in the staged group: three (10.8%) with skin infections, one with central nervous system (CNS) infections, and one with both skin and CNS infections. Overall complications, wound infections, CNS infections, overdrainage, and revision surgery showed no significant differences between the groups. Conclusions: Simultaneous cranioplasty and VPS showed complication rates similar to those of staged operation. © 2019 Formosan Journal of Surgery.

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