TY - JOUR T1 - Dekompresif kraniyektomilerde duraplasti tipi ve komplikasyon oranı: su geçirmez duraplasti ve hızlı kapama yöntemlerinin karşılaştırılması TT - Duraplasty type and complication rate in decompressive craniotomy:comparison of watertight duraplasty and rapid-closure methods AU - Yakar, Fatih PY - 2020 DA - September Y2 - 2020 DO - 10.31362/patd.737575 JF - Pamukkale Medical Journal JO - Pam Med J PB - Pamukkale University WT - DergiPark SN - 1308-0865 SP - 733 EP - 737 VL - 13 IS - 3 LA - tr AB - Amaç: Dekompresif kraniyektomi cerrahisi, nöroşirürji pratiğinde dirençli intrakraniyal hipertansiyonu düşürmek amacıyla sık olarak kullanılan bir yöntemdir. İşlem sırasında tercih edilebilen su geçirmez ya da hızlı kapama şeklinde su geçirmez olmayan duraplasti tipleri mevcuttur. Bu çalışmanın amacı, su geçirmez olmayan duraplastilerin operasyon sonrası dönemdeki komplikasyonları arttırıp arttırmadığını tespit etmektir.Gereç ve yöntem: Eylül 2017-Ocak 2020 tarihleri arasında, farklı endikasyonlarla dekompresif kraniyektomi yapılan 19 hasta çalışmaya dahil edildi. Hastaların demografik bilgileri, perioperatif bulguları, komplikasyonları ve klinik faydalanma oranları değerlendirilmiştir. Bulgular: Çalışmada kadın/erkek oranı 7/12 iken, yaş ortalaması 53,6±17,2 (yaş aralığı:22-82) idi. En sık dekompresif kraniyektomi endikasyonu travmaydı (%37, 7 hasta). Cilt altı sıvı koleksiyonu grup 1’de 1 hastada (%12.%), grup 2’de ise 2 hastada (%18) görüldü. Hastaların hiçbirinde yara yeri revizyonu yapılmadı. Mortal seyreden tüm vakalarda Glasgow koma skoru 8 puanın altında saptanmıştır.Sonuç: Su geçirmez tarzda olmayan hızlı kapama duroplastisi, cerrahi komplikasyon riskini arttırmamaktadır ve güvenli/uygulanabilir bir yöntem olarak değerlendirilmektedir. KW - Dekompresif kraniyektomi KW - duraplasti KW - su geçirmez CR - Referans 1. Carter BS, Ogilvy CS, Candia GJ, Rosas HD, Buonanno F. One-year outcome after decompressive surgery for massive nondominant hemispheric infarction. Neurosurgery 1997;40(6):1168-1175. http://doi:10.1097/00006123-199706000-00010 CR - Referans 2. Vieira E, Guimarães TC, Faquini IV, et al. Randomized controlled study comparing 2 surgical techniques for decompressive craniectomy: With watertight duraplasty and without watertight duraplasty. J Neurosurg 2018;129(4):1017–1023. http://doi:10.3171/2017.4.JNS152954 CR - Referans 3. Bullock MR, Chesnut R, Ghajar J, et al. Surgical Management of Acute Subdural Hematomas. Neurosurgery 2006;58(3 Suppl):16-24. http://doi:10.1227/01.NEU.0000210364.29290.C9 CR - Referans 4. Güresir E, Beck J, Vatter H, et al. Subarachnoid hemorrhage and intracerebral hematoma: Incidence, prognostic factors, and outcome. Neurosurgery 2008;63(6):1088-1093. doi: 10.1227/01.NEU.0000335170.76722.B9 CR - Referans 5. Vahedi K, Hofmeijer J, Juettler E, et al. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 2007;6(3):215-222. http://doi:10.1016/S1474-4422(07)70036-4 CR - Referans 6. Schwab S, Steiner T, Aschoff A, et al. Early hemicraniectomy in patients with complete middle cerebral artery infarction. Stroke 1998;29(9):1888-1893. http://doi:10.1161/01.STR.29.9.1888 CR - Referans 7. Güresir E, Vatter H, Schuss P, et al. Rapid closure technique in decompressive craniectomy. Clinical article. J Neurosurg 2018;129(4):1017-1023. doi: 10.3171/2017.4.JNS152954 CR - Referans 9. Timofeev I, Hutchinson PJ. Outcome after surgical decompression of severe traumatic brain injury. Injury 2006;37(12):1125-1132. http://doi:10.1016/j.injury.2006.07.031 CR - Referans 10. Yang HS, Hyun D, Oh CH, Shim YS, Park H, Kim E. A Faster and Wider Skin Incision Technique for Decompressive Craniectomy: n-Shaped Incision for Decompressive Craniectomy. Korean J Neurotrauma 2016;12(2):72-76. http://doi:10.13004/kjnt.2016.12.2.72 CR - Referans 11. Ragel BT, Klimo P, Martin JE, Teff RJ, Bakken HE, Armonda RA. Wartime decompressive craniectomy: Technique and lessons learned. Neurosurg Focus 2010;28(5):1–10. http://doi:10.3171/2010.3.FOCUS1028 CR - Referans 12. Huang X, Wen L. Technical Considerations in Decompressive Craniectomy in the Treatment of Traumatic Brain Injury. Int J Med Sci 2010;7(6):385-390. http://doi:10.7150/ijms.7.385 CR - Referans 13. Zweckberger K, Erös C, Zimmermann R, Kim SW, Engel D, Plesnila N. Effect of early and delayed decompressive craniectomy on secondary brain damage after controlled cortical impact in mice. J Neurotrauma 2006;23(7):1083-1093. http://doi:10.1089/neu.2006.23.1083 CR - Referans 14. Alexander E, Ball MR, Laster DW. Subtemporal decompression: Radiological observations and Current surgical experience. Br J Neurosurg 1987;1(4):427-433. http://doi:10.3109/02688698708999632 CR - Referans 15. Clark K, Nash TM, Hutchison GC. The failure of circumferential craniotomy in acute traumatic cerebral swelling. J Neurosurg 1968;29(4):367-371. http://doi:10.3171/jns.1968.29.4.0367 CR - Referans 16. Mitchell P, Tseng M, Mendelow AD. Decompressive craniectomy with lattice duraplasty. Acta Neurochir (Wien) 2004;146(2):159-160. http://doi:10.1007/s00701-003-0186-z CR - Referans 17. Ruf B, Heckmann M, Schroth I, et al. Early decompressive craniectomy and duraplasty for refractory intracranial hypertension in children: results of a pilot study. Crit Care 2003;7(6):133–138. http://doi:10.1186/cc2361 CR - Referans 18. Kilincer C, Simsek O, Hamamcioglu MK, Hicdonmez T, Cobanoglu S. Contralateral subdural effusion after aneurysm surgery and decompressive craniectomy: Case report and review of the literature. Clin Neurol Neurosurg 2005;107(5):412-416. http://doi:10.1016/j.clineuro.2004.09.018 CR - Referans 19. Yang XJ, Hong GL, Su SB, Yang SY. Complications induced by decompressive craniectomies after traumatic brain injury. Chin J Traumatol 2003;6(2):99-103. CR - Referans 20. Kombogiorgas D, Jatavallabhula NS, Sgouros S, Josan V, Walsh AR, Hockley AD. Risk factors for developing epilepsy after craniotomy in children. Childs Nerv Syst 2006;22(11):1441-1445. http://doi:10.1007/s00381-006-0117-4 CR - Referans 21. Cushing H. Surgery, Its Principles and Practice. 3rd ed. Saunders; 1908. CR - Referans 22. Barth M, Tuettenberg J, Thomé C, Weiss C, Vajkoczy P, Schmiedek P. Watertight dural closure: Is it necessary? A prospective randomized trial in patients with supratentorial craniotomies. Neurosurgery 2008;63(4 Suppl 2):352-358. http://doi:10.1227/01.NEU.0000310696.52302.99 CR - Referans 23. Sade B, Oya S, Lee JH. Non-watertight dural reconstruction in meningioma surgery: Results in 439 consecutive patients and a review of the literature: Clinical article. Journal of Neurosurgery 2011;114(3):714–718. http://doi:10.3171/2010.7.JNS10460 CR - Referans 24. Holland M, Nakaji P. Craniectomy: Surgical indications and technique. Operative Techniques in Neurosurgery 2004;7(1):10–15. http://doi:10.1053/j.otns.2004.04.006 CR - Referans 25. Kolias AG, Kirkpatrick PJ, Hutchinson PJ. Decompressive craniectomy: Past, present and future. Nature Reviews Neurology 2013;9(7):405–415. http://doi:10.1038/nrneurol.2013.106 CR - Referans 26. Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage: A powerful and easy-to-use predictor of 30-day mortality. Stroke 1993;24(7):987-993. http://doi:10.1161/01.STR.24.7.987 CR - Referans 27. Passero S, Burgalassi L, D’andrea P, Battistini N. Recurrence of bleeding in patients with primary intracerebral hemorrhage. Stroke 1995;26(7):1189-1192. http://doi:10.1161/01.STR.26.7.1189 CR - Referans 28. Carvi Y Nievas MN, Höllerhage HG. Early combined cranioplasty and programmable shunt in patients with skull bone defects and CSF-circulation disorders. Neurol Res 2006;28(2):139-1344. http://doi:10.1179/016164106X98008 UR - https://doi.org/10.31362/patd.737575 L1 - https://dergipark.org.tr/en/download/article-file/1104073 ER -