Cranial stair-step incision for minimizing postoperative complications in neuro-oncologic surgery: A propensity score-matched analysis

Purpose Craniotomies for tumor resection can at times result in wound complications which can be devastating in the treatment of neuro-oncological patients. A cranial stair-step technique was recently introduced as an approach to mitigate these complications, especially in this patient population wh...

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Bibliographic Details
Published in:Acta neurochirurgica 2024-07, Vol.166 (1), p.305, Article 305
Main Authors: Park, John B., Filo, Jean, Rahmani, Benjamin, Adebagbo, Oluwaseun D., Lee, Daniela, Escobar-Domingo, Maria J., Garvey, Shannon R., Arnautovic, Aska, Cauley, Ryan P., Vega, Rafael A.
Format: Article
Language:English
Subjects:
Adult
Aged
Brain Neoplasms - surgery
Cardiovascular disease
Chemoradiotherapy
Complications
Coronary artery disease
Craniotomy - adverse effects
Craniotomy - methods
Female
Heart diseases
Humans
Immunotherapy
Interventional Radiology
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Patients
Population studies
Postoperative
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Propensity Score
Retrospective Studies
Risk factors
Skull
Steroid hormones
Surgery
Surgical Orthopedics
Vascular endothelial growth factor
Wound healing
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Summary:Purpose Craniotomies for tumor resection can at times result in wound complications which can be devastating in the treatment of neuro-oncological patients. A cranial stair-step technique was recently introduced as an approach to mitigate these complications, especially in this patient population who often exhibit additional risk factors including steroids, chemoradiation, and VEGF inhibitor treatments. This study evaluates our cranial stair-step approach by comparing its postoperative complications using propensity score matching with those of a standard craniotomy wound closure. Methods A retrospective chart review was conducted on patients with intracranial neoplasms undergoing primary craniotomy at a single institution. Patients with prior craniotomies and less than three months of follow-up were excluded. Analyses were performed using R Studio. Results 383 patients were included in the study, 139 of whom underwent the stair-step technique while the rest underwent traditional craniotomy closures. The stair-step cohort was older, had higher ASA classes, and had a higher prevalence of coronary artery disease. The stair-step patients were administered fewer steroids before (40.29% vs. 56.56%, p  
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-024-06207-7