Impact of dural closure on postoperative complications in cerebellar metastasis surgery: A retrospective cohort study

Cerebellar metastases represent the second most common location for brain metastases. Surgery is a key therapeutic option, but the rate of postoperative complications remains high. The impact of dural closure techniques on these complications has not yet been specifically evaluated.

We conducted a retrospective single-center study including all patients who underwent surgical resection of cerebellar metastasis between 2012 and 2021 at Caen University Hospital. The primary outcome was the occurrence of a postoperative complication withing 30 days (death, reoperation, or meningitis). We analyzed surgical data, particularly focusing on the type of dural closure: watertight (with sutured closure ± suturable duraplasty) versus non-watertight (non-sealing suture ± non-suturable patch).

A total of 125 surgeries were analyzed. Postoperative complications occurred in 25% of cases, including hydrocephalus (10%), meningitis (9%), and cerebrospinal fluid leaks (8%). Watertight dural closure was significantly associated with a higher rate of complications (p = 0.039). Median overall survival was 10 months and complications were associated with shorter survival (p = 0.011).

Watertight dural closure appears to increase the risk of postoperative complications in cerebellar metastasis surgery. These findings question the relevance of systematic watertight dural suturing in the posterior fossa.