A Single-Center Retrospective Descriptive Cohort Study of 211 Pediatric Patients: Cerebrospinal Fluid Leakage After Fourth Ventricle Tumor Resection

Abstract

Cerebrospinal fluid (CSF) leak remains a significant complication of posterior fossa tumor surgery. The goal of this study was to evaluate the wound CSF leakage rate in pediatric patients who underwent fourth ventricle tumor resection in a single-site setting and to explore the association of CSF leakage with the length of stay in the intensive care unit (ICU) and with dural sealant application. Two hundred and eleven patients who underwent fourth ventricle tumor surgery between 2008 and 2016 were included in this study. Patient data were evaluated retrospectively. Postoperative wound CSF leakage was observed in 6 patients (2.8%). One hundred and seventy-six patients (83.4%) stayed in the ICU for ≤1 day, and CSF leakage developed in 4 of these patients (2.3%). Thirty-five patients (16.6%) stayed in the ICU for >1 day, and CSF leakage was observed in 2 of these patients (5.7%). The observed difference was not statistically significant (P=0.260). There were no statistically significant differences in the CSF leakage rates in groups with and without dural sealing before (n= 2 [3%] and n= 4 [2.8%], respectively; P= 0.99) and after (n= 2 [3.0%] and n= 4 [6.0%], respectively; P= 0.68) application of the propensity score matching algorithm. The low CSF leakage rate (2.8%) identified in this study was associated with a certain algorithm of patient management. There was no strong evidence that the CSF leakage rate was associated with the length of stay in the ICU or with dural sealant application.