Fibrin-coated collagen fleece versus absorbable dural sealant for sellar closure after transsphenoidal pituitary surgery: a comparative study

Spitaels, Julien; Moore, Justin M.; Zaidman, Nathalie; Arroteia, Isabel Fernandes; Appelboom, Geoffrey; Barrit, Sami; Carlot, Sébastien; Maertelaer, Viviane De; Hassid, Sergio; Witte, Olivier De

doi:10.1038/s41598-022-12059-x

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…11 Spitaels et al conducted a review and comparative analysis of Tachosil®, DuraSeal®, and other to methods to prevent CSF leak. 12 After assessing non-randomized controlled trials, they concluded that fibrin sealants are safe and are effective in preventing CSF leaks. In our study, we were able to demonstrate that Hemopatch® can be used safely as a dural sealant in cranial procedures where a watertight dural suture cannot otherwise be achieved.…”

Section: Results Baseline Demographics and Operative Parametersmentioning

confidence: 99%

Hemopatch^®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Aldahash,

Ansary,

Hallak

et al. 2024

NSJ

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Objectives: To determine the effectiveness and safety of Hemopatch® as a primary dural sealant in preventing CSF leakage following cranial surgery. Cerebrospinal fluid )CSF( leaks occur in cranial operations and are associated with significant patient burden and expense. The use of Hemopatch® as a dural sealant in cranial neurosurgical procedures is described and analyzed in this study.Methods: Data were retrospectively collected from all patients who underwent a craniotomy for various neurosurgical indications where Hemopatch® was used as the primary dural sealant between June 2017 and June 2022. Infection and CSF leak were the main indicators evaluated after surgery.Results: A total of 119 consecutive patients met our inclusion criteria. The median was age 41.5 years, and 52.5% were female. The mean follow-up period was 2.3 years )7 months to 6 years(. There were 110 )92.44%( supratentorial and 9 )7.56%( infratentorial craniotomies. Postoperative CSF leak was reported in 2 patients )1.68%(, one in each cohort. Postoperative infection occurred in one patient )0.84%(. Conclusion:The results suggest that using Hemopatch® as a dural sealant in cranial surgery is effective and safe. After supra-/infratentorial craniotomies, the rate of postoperative adverse events in our sample was within the range of known surgical revision rates. Future randomized clinical studies are required to confirm our encouraging findings.

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Section: Results Baseline Demographics and Operative Parametersmentioning

confidence: 99%

Hemopatch^®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Aldahash,

Ansary,

Hallak

et al. 2024

NSJ

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“…On MINORS assessment, the 15 non‐comparative studies averaged a score of 11.6 ± 1.8 out of 16 (range: 8–14) whereas the 12 non‐randomized comparative studies scored 18.0 ± 3.4 out of 24 (range: 10–23) (Supplementary Table 1). Characteristics of all included studies were summarized in Table I 30–34,15,17,35–44,16,45–47,10,48–52 . Three studies reported level III evidence whereas the remaining 24 studies reported level IV evidence.…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of all included studies were summarized in Table I. [30][31][32][33][34]15,17,[35][36][37][38][39][40][41][42][43][44]16,[45][46][47]10,[48][49][50][51][52] Three studies reported level III evidence whereas the remaining 24 studies reported level IV evidence. Patients in the aggregate cohort were 49.0% female and, on average, 50.2 years (range: 1-87).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Tissue Sealant Impact on Skull Base Reconstruction Outcomes: A Systematic Review and Meta‐Analysis

Pang,

Bitner,

Nottoli

et al. 2024

The Laryngoscope

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ObjectiveDespite significant advances in understanding of skull base reconstruction principles, the role of tissue sealants in modifying postoperative cerebrospinal fluid (CSF) leak outcomes remains controversial. We evaluate postoperative CSF leak incidence associated with tissue sealant use in skull base defect repair during endoscopic skull base surgery (ESBS).Data SourcesWeb of Science, PubMed/MEDLINE, Scopus, and Cochrane Library.Review MethodsSystematic review and meta‐analysis of risk differences (RD). A search strategy identified original studies reporting CSF leakage following ESBS with disaggregation by tissue sealant use and/or type.Results27 non‐randomized studies (n = 2,403) were included for qualitative and meta‐analysis. Reconstruction with a tissue sealant did not significantly reduce postoperative CSF leak risk compared with reconstruction without sealant (RD[95% CI] = 0.02[−0.01, 0.05]). Sub‐analyses of dural sealant (−0.02[−0.11, 0.07]) and fibrin glue (0.00[−0.07, 0.07]) compared with no sealant were similarly unremarkable. Postoperative CSF leakage was not significantly modulated in further sub‐analyses of DuraSeal (0.02[−0.02, 0.05]), Adherus (−0.03[−0.08, 0.03]), or Bioglue (−0.06[−0.23, 0.12]) versus no dural sealant use, or Tisseel/Tissucol versus fibrin glue nonuse (0.00[−0.05, 0.05]). No significant association was seen comparing dural sealant use versus fibrin glue use on pairwise (0.01[−0.03, 0.05]) or network meta‐analysis (−0.01[−0.05, 0.04]). Limitations in source literature prevented sub‐analyses stratified by leak characteristics, defect size and location, and accompanying reconstruction materials.ConclusionTissue sealant use did not appear to impact postoperative CSF leak incidence when compared with nonuse. Higher quality studies are warranted to thoroughly elucidate the clinical value of adjunct sealant use in endoscopic skull base reconstruction.Level of EvidenceN/A Laryngoscope, 2024

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“…The choice of the closure technique depends on the flow intensity and on the leak location, as proposed by Conger et al (34). In case of minimal diaphragm oozing, a simple treatment with a collagen sponge can be chosen (64,66,69). Collagen sponge has the great advantage to be easy to use.…”

Section: Discussionmentioning

confidence: 99%

“…( 34 ). In case of minimal diaphragm oozing, a simple treatment with a collagen sponge can be chosen ( 64 , 66 , 69 ). Collagen sponge has the great advantage to be easy to use.…”

Section: Discussionmentioning

confidence: 99%

Closure strategy for endoscopic pituitary surgery: Experience from 3015 patients

et al. 2023

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IntroductionEffective strategies are required to ensure optimal management of the crucial closure step in endoscopic pituitary surgery. Many surgical techniques have been reported but no significant consensus has been defined.MethodsBetween January 2006 and March 2022, 3015 adult patients with pituitary adenomas were operated on by a single expert neurosurgical team, using a mononostril endoscopic endonasal approach. Based of preoperative risk factors of and operative findings, a detailed closure strategy was used. Body mass index >40, sellar floor lysis, number of surgeries>2, large skull base destruction, prior radiotherapy were considered as preoperative risk factors for closure failure. All patients treated with an expanded endonasal approach were excluded.ResultsPatients were mostly women (F/M ratio: 1.4) with a median age of 50 (range: 18 –89). Intraoperative CSF leak requiring specific surgical management was observed in 319/3015 (10.6%) of patients. If intraoperative leak occurred, patients with predictive risk factors were managed using a Foley balloon catheter in case of sellar floor lysis or BMI>40 and a multilayer repair strategy with a vascularized nasoseptal flap in other cases. Postoperative CSF leak occurred in 29/3015 (1%) of patients, while meningitis occurred in 24/3015 (0.8%) of patients. In patients with intraoperative leak, closure management failed in 11/319 (3.4%) of cases.ConclusionBased on our significant 16-year experience, our surgical management is reliable and easy to follow. With a planned and stepwise strategy, the closure step can be optimized and tailored to each patient with a very low failure rate.

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Fibrin-coated collagen fleece versus absorbable dural sealant for sellar closure after transsphenoidal pituitary surgery: a comparative study

Cited by 6 publications

References 22 publications

Hemopatch^®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Hemopatch^®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Tissue Sealant Impact on Skull Base Reconstruction Outcomes: A Systematic Review and Meta‐Analysis

Closure strategy for endoscopic pituitary surgery: Experience from 3015 patients

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Fibrin-coated collagen fleece versus absorbable dural sealant for sellar closure after transsphenoidal pituitary surgery: a comparative study

Cited by 6 publications

References 22 publications

Hemopatch®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Hemopatch®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Tissue Sealant Impact on Skull Base Reconstruction Outcomes: A Systematic Review and Meta‐Analysis

Closure strategy for endoscopic pituitary surgery: Experience from 3015 patients

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Product

Resources

About

Hemopatch^®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study

Hemopatch^®as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study