Turkish Neurosurgery 2024 , Vol 34 , Num 4
Application of Dural Suturing in Reconstruction of Sellar Floor for Cerebrospinal Fluid Leakage During Neuroendoscopic Intranasal Approach Surgery: A Meta-Analysis
Wenmiao LUO1,YuWei DING1,Zhi PENG3,Hengzhu ZHANG1
1The Dalian School of Clinical Medicine of Dalian Medical University, Department of Neurosurgery, Dalian, Liaoning, China
2The Yangzhou School of Clinical Medicine of Dalian Medical College, Department of Neurosurgery, Yangzhou, Jiangsu, China
3Renhe Hospital, Department of Neurosurgery, Yichang, Hubei, China
DOI : 10.5137/1019-5149.JTN.44252-23.2 AIM: To assess the safety and efficacy of utilizing dural suturing as an adjunctive procedure for saddle floor reconstruction in patients undergoing endoscopic surgery in the sellar region.

MATERIAL and METHODS: According to the PRISMA guidelines, we searched the literature on sellar floor reconstruction in endoscopic sellar surgery. Fixed- or random-effects meta-analysis was used to pool the rate of return to postoperative cerebrospinal fluid (poCSF) leakage, repair operations, postoperative hospitalization, complete resection, infection, lumbar drainage (LD), and operative duration.

RESULTS: A total of six studies involving 723 participants were included in the current meta-analysis. The pooled results demonstrated that patients in the dural suturing group had a lower incidence of poCSF leakage [odds ratio (OR), 0.18; 95% confidence interval (CI), 0.07 ? 0.44; p=0.0002] and repair operation [OR, 0.24; 95% CI, 0.07 ? 0.78; p=0.02], as well as a shorter hospitalization period [standardized mean difference (SMD), -0.45; 95% CI, -0.62 ? -0.28; p<0.00001]. There was no significant difference between the two groups in terms of the complete resection [OR, 1.06; 95% CI, 0.62 ? 1.80; p=0.84], postoperative infection [OR, 0.49; 95% CI, 0.21 ? 1.15; p=0.10] and lumbar drainage (LD) [OR, 0.28; 95% CI, 0.06 ? 1.23; p=0.09]. Additionally, the dural suturing group may require a longer operative duration [SMD, 0.29; 95% CI, 0.02 ? 0.56; p=0.03].

CONCLUSION: The results suggest that dural suturing can be advantageous in reducing postoperative complications and shortening postoperative hospitalization following neuroendoscopic surgery in the sellar region without increasing the risk of infection. Keywords : Neuroendoscope, Sellar base repair, Cerebrospinal fluid leak, Dural suture, Meta-analysis

Corresponding author : Hengzhu ZHANG, zhanghengzhu@sina.com