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Anesthesia for Endoscopic Strip Craniectomy Repair: A Single-Center Retrospective Cohort Study.

Kira Achaibar¹, Holly Graham¹, Shammi Kakad¹

¹Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

Paediatric Anaesthesia

|July 7, 2025

Summary

Endoscopic strip craniectomy for infant craniosynostosis repair is effective, with most patients discharged on postoperative day 1. However, a significant transfusion rate, particularly for metopic repairs, warrants attention.

Keywords:

blood transfusion craniofacial surgery endoscopic strip craniectomy minimally invasive neurosurgery pediatric

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Area of Science:

Pediatric Surgery
Neurosurgery
Anesthesiology

Background:

Craniosynostosis requires surgical intervention in infants.
Endoscopic strip craniectomy offers a minimally invasive approach.
Infants undergoing surgery may face risks like blood loss.

Purpose of the Study:

Evaluate institutional experience with endoscopic strip craniectomy.
Analyze perioperative parameters, transfusion rates, complications, and hospital stay.
Assess the safety and outcomes of this minimally invasive technique.

Main Methods:

Retrospective observational study of 111 infants.
Data collected from 2019-2024 at Great Ormond Street Hospital.
Analysis of physiological parameters, transfusion rates, and complications.

Main Results:

The study included 111 infants undergoing various suture repairs.
Mean operative time was 73 minutes; multisuture repairs took longer.
A 20% red cell transfusion rate was observed, higher in metopic repairs (26%).
95% of infants were discharged on postoperative day 1 with minimal complications.

Conclusions:

Endoscopic strip craniectomy is a safe and effective minimally invasive procedure.
A notable transfusion rate exists, especially for metopic repairs.
Further attention to blood loss management in specific infant populations is recommended.