Securing Hemostasis in Pediatric Low-Grade Posterior Cerebral Fossa Tumors: The Value of Thrombin-Gelatin Hemostatic Matrix

Baro, Valentina; Denaro, Luca; D’Avella, Domenico

doi:10.1159/000491824

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…In recent years, numerous substances have been introduced into surgical practice to obtain haemostasis in malignant brain tumours [3][4][5]. Adequate haemostasis in cranial and spinal surgery is paramount.…”

Section: Discussionmentioning

confidence: 99%

Haemostatic technique in malignant gliomas

Dobran

Somma

Paracino

2022

Neurol Neurochir Pol.

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Introduction.Haemostasis in brain surgery is mandatory to avoid postoperative re-bleeding and a poor outcome. Postoperative intra-cavity haemorrhage is a frequent complication, especially in surgery of malignant gliomas because of the fragility of pathological vessels. Material and methods.In this technical note, we describe our 'compression' technique used to achieve haemostasis in adult patients who underwent surgery for supratentorial malignant gliomas (GBM) at our Institute from January 2019 to January 2022. Peri-operative work-up included clinical status, laboratory data and contrast brain CT, performed at 24 hours after surgery, or earlier for patients with neurological worsening.Results. A total of 82 patients was included in this study, 46 males (57%) and 36 females (43%). A post-operative intra-cavity haemorrhage was documented by postoperative CT-scan in 3/82 patients (3.65%), and the mean surgical time was 3.66 hours. No late bleeding was observed 48 hours after surgery. Conclusions.We have documented the good results of our technique to achieve haemostasis in patients operated for malignant glioma (GBM). The technique described in this study seems to be safe and useful to avoid post-operative bleeding in the surgery of cerebral GBM.

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Section: Discussionmentioning

confidence: 99%

Haemostatic technique in malignant gliomas

Dobran

Somma

Paracino

2022

Neurol Neurochir Pol.

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“…A careful haemostasis during tumour removal should be performed also to obtain a clear vision of surgical field, especially in the farthest area or near the brainstem where the haemostasis could be difficult to achieve. Some haemostatic agents could be very helpful in this setting to achieve valid control of ooze bleeding in prohibitive regions 18 . SNC parenchyma decompression (obtained by the opening of basal cisterns or by tumour removal) should not be rapidly performed to avoid bleeding from bridging veins and small arteries.…”

Section: Advancements and Open Issuesmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

101

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SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

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Blood Loss and Transfusion in Children Undergoing Neurosurgery

Mishra

Rath

2021

Fundamentals of Pediatric Neuroanesthesia

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Securing Hemostasis in Pediatric Low-Grade Posterior Cerebral Fossa Tumors: The Value of Thrombin-Gelatin Hemostatic Matrix

Cited by 5 publications

References 20 publications

Haemostatic technique in malignant gliomas

Haemostatic technique in malignant gliomas

Surgery of the lateral skull base: a 50-year endeavour

Blood Loss and Transfusion in Children Undergoing Neurosurgery

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