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Sealing of cerebrospinal fluid leakage during conventional transsphenoidal surgery using a fibrin-coated collagen fleece

Title
 Sealing of cerebrospinal fluid leakage during conventional transsphenoidal surgery using a fibrin-coated collagen fleece
Authors
 Chang Ki Hong; Yong Bae Kim; Kyu Sung Lee; Je Beom Hong
Issue Date
2015
Journal Title
 Journal of Clinical Neuroscience
ISSN
 0967-5868
Citation
 Journal of Clinical Neuroscience, Vol.22(4) : 696~699, 2015
Abstract
The prevention of cerebrospinal fluid (CSF) leakage is a key feature of the transsphenoidal approach (TSA) to the pituitary fossa. Although fibrin-coated collagen fleece (Tachosil, Nycomed, Linz, Austria) is a powerful topical hemostatic agent whose usage is increasing in open neurosurgery, the use of Tachosil in TSA surgery has not yet gained wide clinical acceptance. We retrospectively evaluated whether the lone use of Tachosil without additional packing material or postoperative lumbar drainage was effective to prevent CSF leakage in TSA surgery in 101 patients. Additionally, we compared it to a conventional sellar closure technique in 54 patients. Only two (1.9%) of the patients in the Tachosil application group developed postoperative CSF rhinorrhea. No other postoperative complications occurred, including infection or material detachment. However, in the conventional packing group, five (9.3%) patients developed postoperative CSF rhinorrhea and one (1.9%) developed meningitis during the postoperative period. The mean length of postoperative hospital stay was significantly shorter in the Tachosil treatment group than in the standard closure group. These results may indicate that sellar repair using Tachosil can be effective to prevent CSF leakage after TSA surgery, and obviate the need for an autologous tissue graft or postoperative lumbar drainage.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/140487
DOI
10.1016/j.jocn.2014.10.019
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Neurosurgery
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0967586814006705
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