Methods of Hemostasis in Cranial Neurosurgery: An Anatomy-Based Stepwise Review.

Autor: Delawan M; College of Medicine, Gulf Medical University, Ajman, United Arab Emirates., Sharma M; Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA., Ismail M; Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq., Algabri MH; College of Medicine, Baghdad University, Baghdad, Iraq., Abdalridha RH; College of Medicine, Babylon University, Babylon, Iraq., Alawadi MN; College of Medicine, Baghdad University, Baghdad, Iraq., Alayyaf AS; College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj, Riyadh, Saudi Arabia., Alrawi MA; Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq., Andaluz N; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Hoz SS; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Electronic address: hozsamer2055@gmail.com.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2023 Oct; Vol. 178, pp. 241-259.e3. Date of Electronic Publication: 2023 Aug 14.
DOI: 10.1016/j.wneu.2023.08.030
Abstrakt: Background: Hemostasis is crucial in preventing hemorrhage during cranial neurosurgical procedures and maintaining visualization of the surgical field. There is significant variation in the availability of hemostatic methods across different settings and hemostatic techniques are being continuously developed over the decades of practicing neurosurgery. The aim of this article is to provide an outline of the potential methods to achieve hemostasis based on the sequential operative anatomy of a cranial operation.
Methods: A systematic review was conducted following the PRISMA guidelines. The PubMed database was searched from inception of the database to July 18, 2023. A total of 64 studies were identified fulfilling predefined inclusion criteria, and the risk of bias was assessed using the Joanna Briggs Institute checklists.
Results: Seventy-one hemostatic agents, techniques, tools, and devices were identified, which were then categorized according to the operative phase for which they are indicated. Nine operative anatomic targets were addressed in the sequence in which they are involved during a cranial procedure. For each anatomic target, the following number of hemostatic techniques/agents were identified: 11 for scalp, 3 for periosteum, 10 for skull bone, 11 for dura mater, 9 for venous sinuses, 5 for arteries, 6 for veins, 12 for brain parenchyma, and 4 for cerebral ventricles.
Conclusions: Depending on the phase of the surgery and the anatomic structure involved, the selection of the appropriate hemostatic method is determined by the source of bleeding. Surgeon awareness of all the potential techniques that can be applied to achieve hemostasis is paramount, especially when faced with operative nuances and difficult-to-control bleeding during cranial neurosurgical procedures.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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