Antibiotics Prophylaxis for Endoscopic Endonasal Approach for Skull Base Tumor Surgery: A Meta-Analysis

被引:7
作者
Kwon, Taek Hyun [1 ]
Shin, Hong Kyung [2 ]
Yoon, Won Ki [1 ]
Kim, Jong Hyun [1 ]
Byun, Joonho [1 ]
机构
[1] Korea Univ, Guro Hosp, Coll Med, Dept Neurosurg, Seoul, South Korea
[2] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Neurol Surg, Seoul, South Korea
关键词
Antibiotic; Endoscopic; Endonasal; Infection; TRANSSPHENOIDAL SURGERY; PITUITARY; MENINGITIS; REGIMEN; RISK; COMPLICATIONS; INFECTION; TRENDS;
D O I
10.1016/j.wneu.2023.02.143
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: The regimen of prophylactic antibiotic for endoscopic endonasal skull base surgery (EE-SBS) varies considerably depending on surgeons and their in-stitutes. The purpose of the present meta-analysis is to assess the effect of antibiotic regimens on EE-SBS surgery for anterior skull base tumor.METHODS: The PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched through October 15, 2022. -RESULTS: The 20 included studies were all retrospec-tive. The studies included a total of 10,735 patients who -nderwent EE-SBS for skull base tumor. The proportion of patients with postoperative intracranial infection across all 20 studies was 0.9% (95% confidence interval [CI] 0.5%-1.3%). The proportion of postoperative intracranial infection in the multiple antibiotics group did not show statistically significant difference to that of the single antibiotic agent group (proportion: 0.6%, 95% CI 0%-1.4% vs. proportion: 1%, 95% CI 0.6%-1.5%, respectively, P = 0.39). The ultra-short duration maintenance group showed lower incidence of postoperative intracranial infection, although it did not reach statistical significance (ultra-short group: 0.7%, 95% CI 0.5%-0.9%; short duration: 1.8%, 95% CI 0.5%-3%; and long duration: 1%, 95% CI 0.2%-1.9%, P = 0.22) The combination of the multiple antibiotics group did not show meaningful low incidence of postoperative intracranial infection (antibiotics combi-nation group: 0.6%, 95% CI 0%-1.4%; cefazolin single group: 0.8%, 95% CI 0%-1.6%; and single antibiotics other than cefazolin: 1.2%, 95% CI 0.7%-1.7%, P = 0.22).CONCLUSIONS: Multiple antibiotics did not show su-periority compared with single antibiotic agent. Also, long maintenance duration of antibiotics did not reduce the incidence of postoperative intracranial infection.
引用
收藏
页码:E82 / E91
页数:10
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