Study on the effect of modified subdural patch with intermittent suture on prevention of complications after supratentorial craniotomy

Abstract

Objective To investigate the incidence of related complications after different surgical types to repair dural defects during supratentorial craniocerebral operation, and to discuss which surgical types has the most advantages in clinical application. Methods A total of 135 cases (Supratentorial Craniotomy operated by the same surgeon) were enrolled retrospectively from May 2018 to May 2019. According to the performed surgical type, the 135 cases were divided into experimental and control group. The experimental group (71 cases) was repaired by modified interrupted suture with patch, the control group (64 cases) was repaired by continuous suture with autologous periosteum or galea aponeurotica. We compared the consuming time of repair, postoperative drainage volume 24 h after operation, and the incidence of complications such as postoperative epilepsy, epidural effusion and subcutaneous hydrops, and the statistical analysis was carried out to the related index. Results The average consuming time of experimental group was significantly shorter than that of control group (experimental group: 12 min; control group: 25 min), the average epidural drainage volume in the experimental group (278 mL) was higher than that in the control group (245 mL) at 24 h after operation. Among the experimental group, 1 case (1.41%) had subcutaneous hydrops, which was significantly lower than control group (10.94%). The incidence of postoperative epilepsy within 3 months in control group was significantly higher than experimental group (experimental group: 2.82%; control group: 14.06%), the difference is statistically significant (P 0.05). There was no special treatment to 7 epidural effusion cases without clinical symotoms, waiting for it to absorb on its own. All 8 cases of subcutaneous hydrops were cured by lumbar cistern drainage. Ten patients developed epileptic seizures 3 months after operation. Symptoms were controlled after regular antiepileptic treatment and were followed up. Conclusion Modified interrupted suture with patch can be used in kinds of dural defects during supratentorial craniocerebral operation, it has obvious advantages in shortening operation time, preventing related complications including subcutaneous hydrops and postoperative epilepsy, and is worthy of clinical promotion. Key words: Supratentorial craniocerebral operation; Repair dural; Patch; Epilepsy; Subcutaneous hydrops; Interrupted suture