Document Detail

Sellar repair with resorbable polyglactin acid sheet and fibrin glue in endoscopic endonasal transsphenoidal surgery.
MedLine Citation:
PMID:  17210302     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cerebrospinal fluid leakage after transsphenoidal surgery represents a serious problem. Various methods to prevent postoperative CSF leakage are available, but immediate and tight dural closure is still difficult. The efficacy of a novel sellar repair was described. METHODS: The sellar repair using absorbable PGA sheet and fibrin glue was applied to 18 consecutive patients with sellar tumors that include 13 pituitary adenomas, 2 craniopharyngiomas, 2 Rathke's cleft cysts, and 1 meningioma within 135 patients who were treated with endoscopic endonasal transsphenoidal approach. The reaction speed and strength between PGA sheets and fibrin glue were examined in vitro. RESULTS: Polyglactin acid sheets were adhered to the rabbit skin with fibrin glue within 3 minutes and withstood a pressure of more than 220 mm Hg. Postoperative CSF leakage of the patients was not observed in any patients, and excellent adhesion of the PGA sheets to surrounding mucosa was estimated by endoscopic observation after the surgery. CONCLUSIONS: Repair of the sellar floor with PGA sheet and fibrin glue is a safe and effective method to prevent postoperative CSF leakage, which decreases the necessity for lumbar drainage after the operation.
Shigetoshi Yano; Hiromasa Tsuiki; Mareina Kudo; Yutaka Kai; Motohiro Morioka; Hideo Takeshima; Eiji Yumoto; Jun-ichi Kuratsu
Publication Detail:
Type:  Journal Article     Date:  2006-11-03
Journal Detail:
Title:  Surgical neurology     Volume:  67     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-09     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  59-64; discussion 64     Citation Subset:  IM    
Department of Neurosurgery, Kumamoto University Graduate School, Kumamoto 860-8556, Japan.
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MeSH Terms
Absorbable Implants*
Adenoma / surgery
Craniopharyngioma / surgery
Fibrin Tissue Adhesive / therapeutic use*
Follow-Up Studies
Meningioma / surgery
Middle Aged
Pituitary Neoplasms / surgery*
Polyglactin 910 / therapeutic use*
Sella Turcica / pathology,  surgery*
Sphenoid Sinus / surgery
Tissue Adhesives / therapeutic use*
Reg. No./Substance:
0/Fibrin Tissue Adhesive; 0/Tissue Adhesives; 34346-01-5/Polyglactin 910

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