gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Early and late cranioplasty in patients that underwent decompressive craniectomy for trauma: A systematic review and meta-analysis of cohort studies

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  • Feng Zheng - Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Xintong Zhang - Department of Neurosurgery, The Second Clinical Medical School of Inner Mongolia University for the Nationalities (Inner Mongolia Forestry General Hospital), Inner Mongolia, China
  • Niklas Von Spreckelsen - Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Pantelis Stavrinou - Neurochirurgische Abteilung, Uniklinik Köln, Uniklinik Köln, Köln, Deutschland
  • Marco Timmer - Allgemeine Neurochirurgie, Uniklinik Köln, Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Roland Goldbrunner - Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Boris Krischek - Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 182

doi: 10.3205/17dgnc745, urn:nbn:de:0183-17dgnc7452

Published: June 9, 2017

© 2017 Zheng et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: To compare occurrence of postoperative complications and mean operating time in early (< 3 months) versus late (> 3 months) cranioplasty, in trauma patients who had undergone a decompressive craniectomy (DC).

Methods: The authors present a systematic review and meta-analysis of the postoperative overall complication rate, infection rate, subdural fluid collection and operating time in cranioplasty of patients who had received a DC for trauma. The data bases PubMed, EMBASE and the Cochrane Library were systematically searched.

Results: Five cohort studies, comprising 413 patients, were included in a quantitative analysis. There was no significant difference between the early and late cranioplasty cohorts in overall postoperative complications [RR=0.68, 95%CI (0.36, 1.29), p > 0.05] and postoperative infection rate [RR=0.50, 95%CI (0.20, 1.24), p > 0.05]. Significant differences were found in postoperative subdural fluid collection [RR=0.24, 95%CI (0.07, 0.78), p<0.05] and the mean operative time [mean difference = −33.02, 95%CI (−48.19, −17.84), p < 0.05], both in favor of early cranioplasty.

Conclusion: Regarding overall postoperative complications as well as infections there was no significant difference between early and late cranioplasty. However, in early cranioplasty a significantly shorter operation time, as well as less postoperative subdural fluid collection was observed. Therefore, an early cranioplasty should be considered in these patients.