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Subperiosteal/subgaleal drainage vs. subdural drainage for chronic subdural hematoma: A meta-analysis of
Chunhui Chen1, Yu Xiong1, Xinyue Huang1
1Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China.
Insights
For chronic subdural hematoma (CSDH), neither subdural drainage (SDD) nor subperiosteal/subgaleal drainage (SPGD) significantly impacts recurrence, mortality, or complications. SPGD is a viable alternative for CSDH treatment.
Area of Science:
- Neurosurgery
- Medical Technology
- Clinical Research
Background:
- Chronic subdural hematoma (CSDH) management typically involves surgical evacuation and drainage.
- Optimal placement of indwelling drainage tubes for CSDH remains an area of investigation.
- Ensuring effective blood clot removal and preventing re-aggregation is crucial post-surgery.
Conclusions:
- The choice between SDD and SPGD does not significantly influence CSDH prognosis.
- Subperiosteal/subgaleal drainage (SPGD) presents a valid alternative treatment option for chronic subdural hematoma.
- Further research may explore patient-specific factors influencing drainage method selection.
Background:
Chronic subdural hematoma (CSDH) is commonly treated via surgical removal of the hematoma, placement of a routine indwelling drainage tube, and continuous drainage to ensure that the blood does not re-aggregate following removal. However, the optimal location for placement of the drainage tube remains to be determined.
Objectives:
To aid in establishing a reference for selecting the optimal method, we compared the effects of different drainage tube placements on CSDH prognosis via a systematic review and meta-analysis of previous clinical studies.
Data Sources:
PubMed, Embase, and Cochrane databases.
Study Eligibility Criteria:
We searched for clinical studies comparing the outcomes of subperiosteal/subgaleal drainage (SPGD) and subdural drainage (SDD) for CSDH published in English prior to April 1, 2022.
Participants:
The final analysis included 15 studies involving 4,318 patients.
Results:
Our analysis of the pooled results revealed no significant differences in recurrence rate between the SDD and SPGD groups. We also observed no significant differences in mortality or rates of postoperative complications (infection, pneumocephalus, or epilepsy) between the SDD and SPGD groups.
Conclusions:
These results suggest that the choice of SDD vs. SPGD has no significant effect on CSDH prognosis, highlighting SPGD as an alternative treatment option for CSDH.
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