The comparison of the watertight and non-watertight dural closure in supratentorial craniotomy: a single-institute 10-year experience with 698 patients

Abstract

Abstract Objective: Many neurosurgeons regard the watertight dural closure to be critical in cranial base surgery, infratentorial craniotomy, and spinal intradural procedure. Whether watertight dural closure also reduce complications remains controversial in supratentorial craniotomy. This study seeks to determine whether a watertight dural closure is associated with fewer complications during supratentorial craniotomy for intracranial space occupying lesion removal.Methods: A retrospective analysis of patients who suffered from intracranial space occupying lesions at Beijing Ditan Hospital between January 2011 and December 2021 was conducted. A total of 698 cases were reviewed with attention to the operative approach, subgaleal fluid collection, wound healing impairment, postoperative infection, and post-craniotomy headaches.Results: A total of 423 patients with and 275 without dural watertight closure were included in this study, treated with supratentorial craniotomies. Patients without WTDC had a significantly higher rate of infection (10.9% vs 4.5% with WTDC, p = 0.001). The WTDC group had a rate of 9.7% in subgaleal fluid collection, while the non-WTDC group had a rate of 11.3%, although this difference was not significant (p = 0.502). They suffered from a greater incidence of post-craniotomy headaches in the WTDC group (13.5% vs.9.5% in the non-WTDC group), but without statistical significance (p=0.109). We also found no difference in wound healing impairment (p = 0.719).Conclusions: There is less postoperative infection associated with watertight dural closure during intracranial space occupying lesion removal than without watertight dural closure in supratentorial craniotomy.