A Comparison of Subperiosteal or Subgaleal Drainage with Subdural Drainage on the Outcomes of Chronic Subdural Hematoma: A Meta-Analysis
| Autor: | Daoyang Zhou, Shuxu Yang, Yonglin Xie, Qin Lu, Cameron Lenahan, Xuchen Qi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Cochrane Library 03 medical and health sciences 0302 clinical medicine Pneumocephalus Modified Rankin Scale Recurrence medicine Humans Craniotomy business.industry Incidence (epidemiology) Glasgow Outcome Scale Odds ratio medicine.disease Confidence interval Surgery Treatment Outcome 030220 oncology & carcinogenesis Hematoma Subdural Chronic Drainage Neurology (clinical) business Epidemiologic Methods 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 135 |
| ISSN: | 1878-8769 |
| Popis: | Objective The aim of the present study was to compare the outcomes of patients with chronic subdural hematoma after undergoing burr hole craniotomy with subperiosteal or subgaleal drainage (SPGD) with those of patients who have undergone burr hole craniotomy with subdural drainage. Methods We searched 4 databases (PubMed, Web of Science, Embase, and Cochrane Library) for relevant reports from January 1995 to September 2019. Two reviewers recorded the major outcomes data as follows: recurrence, mortality, postoperative seizures, postoperative bleeding events, surgical infection, pneumocephalus, modified Rankin scale scores, and Glasgow outcome scale scores. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results A total of 3149 patients from 10 studies were included in our analysis. Compared with the SSD group, the SPGD group had a lower recurrence rate (OR, 0.72; 95% CI, 0.57–0.91) and a smaller risk of postoperative bleeding (OR, 0.41; 95% CI, 0.22–0.78). Also, no significant differences were found in the incidence of mortality (OR, 0.79; 95% CI, 0.54–1.18), postoperative seizures (OR, 0.74; 95% CI, 0.39–1.40), surgical infection (OR, 0.98; 95% CI, 0.55–1.76), pneumocephalus (OR, 0.58; 95% CI, 0.28–1.20), modified Rankin scale score 0–3 (OR, 1.04 at discharge; OR, 1.33 at 6 months), and Glasgow outcome scale score 4–5 (OR, 1.48; 95% CI, 0.82–2.67). Conclusions Burr hole craniotomy with SPGD can be recommended as an effective and safe surgical therapy for patients with chronic subdural hematoma owing to its lower recurrence rate and reduced incidence of postoperative brain injuries, in addition to no increase in the rate of some postoperative complications. However, more studies are necessary for further confirmation. |
| Databáze: | OpenAIRE |
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