Key result
Planned systematic review evaluates cisternostomy versus decompressive craniectomy for severe traumatic brain injury.
Why the study?
Decompressive craniectomy for traumatic brain injury causes serious complications, while cisternostomy has emerged as a treatment whose therapeutic effects independently or as an adjunctive therapy require evaluation across available trials and observational studies.
Does cisternostomy reduce cerebral edema and the associated complications when compared with decompressive craniectomy in managing TBI?
Systematic Review
Does cisternostomy reduce cerebral edema and the associated complications when compared with decompressive craniectomy in managing TBI?
This is a protocol for a systematic review and meta-analysis to evaluate the therapeutic effect of cisternostomy versus decompressive craniectomy in patients with severe traumatic brain injury.
No immediate practice change from this protocol; leaves open the relative benefits of cisternostomy versus decompressive craniectomy in severe TBI.
Background Traumatic brain injury (TBI) is a critical problem which portends an intensive burden with increased mortality and disability affecting more the young population worldwide. The primary goal of TBI treatment is to control intracranial pressure (ICP) and to prevent he devastating effect of secondary brain insult. For over a hundred years decompressive craniectomy has been a standard surgical intervention for treatment of TBI, however it is not without harm since it causes serious complications including meningitis, subdural hygroma, hydrocephalous and increased reoperation rate. Cisternostomy is the most recently introduced intervention for management of cerebral edema Cisternostomy has proven its efficiency a standalone treatment as an adjunctive to decompressive craniectomy in treatment of severe traumatic brain injury. This review aims at investigating the therapeutic effects of cisternostomy when used independently or as an adjunctive to decompressive craniectomy (DC) across the available randomized clinical trials (RCTs) and non randomized studies of effect intervention (NRSI) sectional studies to optimize the strength of evidence for underpinning the strategy for treatment of traumatic brain injury. Methods and Analysis We will conduct the systematic review and meta-analysis by employing the provisions of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guideline and the review protocol has been submitted to International Prospective Register of Systematic Reviews (PROSPERO) for registration before commencement of the study. We will construct the search strategy using the all field terms, medical subheading terms [MeSH Terms] with all permutations combined with Boolean operators such as AND and OR. PubMed, EMBASE, Scopus, COCHRAINE, Web Of Science, Global Index Medicus, Semantic Scholar and Google Scholar electronic databases will be searched. Ethical Consideration and Dissemination This review will not include any human participant such that the ethical clearance approval is not applicable. The protocol of this review has been registered at PROSPERO ID CRD42023400894 . We will disseminate the final report of this review to local and international scientific conferences and The results of this review will be submitted for publication in the Journal of Neurotrauma.
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Kyaruzi et al. (2023) conducted a systematic review in Traumatic Brain Injury. Cisternostomy vs. Decompressive craniectomy was evaluated on Recovery time, length of ICU admission, ventilation duration, length of hospital stay, and procedural associated complications. Cisternostomy and its therapeutic effects compared to decompressive craniectomy in the management of severe traumatic brain injury will be evaluated in this planned systematic review and meta-analysis.
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