World neurosurgery · 2026
Safety and Efficacy of Simultaneous versus Staged Cranioplasty and Ventriculoperitoneal Shunt Placement after Decompressive Craniectomy: A Retrospective Cohort Study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kuo Yi-Hsien, Fu Kuan-Hao, Chen Ying-Yun, Yang Chia-Hsien, Yan Jiun-Lin
Аннотация
BACKGROUND: Decompressive craniectomy (DC) is lifesaving for refractory intracranial hypertension but frequently leaves a cranial defect and may be followed by hydrocephalus. The optimal timing of cranioplasty (CP) and ventriculoperitoneal shunt (VPS) placement remains controversial.
METHODS: We retrospectively reviewed 40 adults who underwent both CP and VPS after DC at a regional trauma hospital in Taiwan between 2015 and 2022. Patients were grouped as staged surgery (n=16) or simultaneous surgery (n=24). Postoperative complications, 3-month Glasgow Coma Scale (GCS), ECOG Performance Status (ECOG-PS), mortality, and hospital stay were compared.
RESULTS: Overall complication rates were identical in the staged and simultaneous groups (25.0% vs. 25.0%, P=1.000). No significant between-group differences were found in age, sex, body mass index, comorbidities, 3-month GCS (11 ± 2.6 vs. 12 ± 3.0, P=0.694), ECOG-PS (3.6 ± 1.0 vs. 3.5 ± 0.9, P=0.462), mortality (13% vs. 4.2%, P=0.553), or hospital stay (42 ± 17 vs. 53 ± 20 days, P=0.089).
CONCLUSIONS: Simultaneous CP and VPS placement was not associated with increased perioperative complications or worse short-term functional outcomes compared with staged surgery in this small sample. In appropriately selected patients, the simultaneous strategy appears to be a safe and practical alternative in our hands.
METHODS: We retrospectively reviewed 40 adults who underwent both CP and VPS after DC at a regional trauma hospital in Taiwan between 2015 and 2022. Patients were grouped as staged surgery (n=16) or simultaneous surgery (n=24). Postoperative complications, 3-month Glasgow Coma Scale (GCS), ECOG Performance Status (ECOG-PS), mortality, and hospital stay were compared.
RESULTS: Overall complication rates were identical in the staged and simultaneous groups (25.0% vs. 25.0%, P=1.000). No significant between-group differences were found in age, sex, body mass index, comorbidities, 3-month GCS (11 ± 2.6 vs. 12 ± 3.0, P=0.694), ECOG-PS (3.6 ± 1.0 vs. 3.5 ± 0.9, P=0.462), mortality (13% vs. 4.2%, P=0.553), or hospital stay (42 ± 17 vs. 53 ± 20 days, P=0.089).
CONCLUSIONS: Simultaneous CP and VPS placement was not associated with increased perioperative complications or worse short-term functional outcomes compared with staged surgery in this small sample. In appropriately selected patients, the simultaneous strategy appears to be a safe and practical alternative in our hands.