Use of an Expanded Polytetrafluoroethylene (ePTFE) Dura Substitute in Glioma Surgeries: A Technical Note

Abstract

Introduction Reoperations are a common scenario among glioma patients. There is crescent evidence of its benefit in low- and high-grade gliomas. Here we discuss our experience with inert expanded polytetrafluoroethylene (ePTFE) dura substitute in glioma surgeries.

Technical note We generally put the ePTFE dura substitute below the dura of the patient, even if it is intact. This membrane should be sutured in place using a tension-free technique, with 4-0 polypropylene. Expanded polytetrafluoroethylene minimizes tissue attachment and fibrosis when performing reoperation in glioma patients.

Discussion Since the literature has shown benefits in survival with reoperation in glioma patients, the use of ePTFE dura substitute can improve surgical time and minimize complications in a second surgery.

Resumo

Introdução Reoperações são comuns entre pacientes portadores de glioma, com crescente evidenência de seu benefício em casos de baixo e alto graus. Aqui discutimos nossa experiência com o substituto dural politetrafluoroetileno expandido (ePTFE) em cirurgias de glioma.

Nota técnica Geralmente colocamos o substituto dural ePTFE abaixo da dura-máter do paciente, mesmo quando intacta. Essa membrana deve ser suturadasem tensão com fio prolene 4.0. ePTFE minimiza aderência tecidual e fibrose, facilitando as reoperações em pacientes com glioma.

Discussão Haja vista a melhora da sobrevida em pacientes com glioma submetidos a reoperações já demonstrada na literatura, o uso do dusbtituto dural ePTFE pode diminuir o tempo cirúrgico e minimizar complicações em reoperações.

Keywords

reoperation - glioma - dura substitute - surgical complication

Palavras-chave

reoperação - glioma - substituto dural - complicação cirúrgica

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