Cabrilo, Ivan;
Marcus, Hani J;
Dorward, Neil L;
(2023)
The cruciform drain: a technical note on the surgical management of cystic lesions of the sella.
British Journal of Neurosurgery
, 37
(5)
pp. 1379-1386.
10.1080/02688697.2020.1849546.
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Abstract
Background: The postoperative recurrence of cystic lesions of the sella is frequent and may require further surgery for re-drainage. / Objective: To tackle this problem, we propose to insert a small cross-shaped drain coursing from the cyst lumen to the suprasellar cistern. At this early stage of innovation, the technique is primarily intended for patients who present with a recurrence. / Methods: The cruciform drain is fashioned from the tip of a ventricular catheter and is inserted under endoscopic vision. We retrospectively reviewed the pre- and postoperative records of patients in whom this technique was implemented. / Results: A cruciform drain was placed in five patients since the introduction of the technique into our practice in 2018. The use of the cruciform drain did not impact upon the expected surgical workflow nor was it associated with adverse intraoperative events, but three patients did develop a postoperative CSF leak that was successfully treated in all cases. None of the patients showed re-collection of their cysts on early radiological follow-up. / Conclusion: The cruciform drain is intended to prevent the renewed build-up of cystic fluid by allowing it to flow through and around the drain into the subarachnoid space. We have modified our repair protocol in response to the observed high CSF leak rate, as a basis for further development of the technique. Studies involving long-term follow-up will also be required to assess its efficacy in reducing cyst recurrence.
| Type: | Article |
|---|---|
| Title: | The cruciform drain: a technical note on the surgical management of cystic lesions of the sella |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1080/02688697.2020.1849546 |
| Publisher version: | https://doi.org/10.1080/02688697.2020.1849546 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Cyst fenestration, permanent drain, prevention of recurrence, sellar cystic lesions, transsphenoidal surgery |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10119613 |
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