Investigating the Effect of Drainage Tube Placement Depth on The Draining Effect of Chronic Subdural Hematoma Surgery

Background: To investigate the effect of drainage tube placement depth on the draining effect of drilling and drainage surgery on chronic subdural hematoma (CSDH).

Methods: 80 patients with CSDH who were admitted to our hospital from July 2017 to June 2019 were included in this study. They were divided into two groups, 40 cases in each group. In the observation group, the drainage tube was placed at 2cm depth; in the control group, the drainage tube was placed to forehead direction, with a depth of 6 cm. The drainage tube removal time (<2 days, 2-5 days, > 5 days), the incidence of intracranial gas accumulation, the incidence of complications, and the recurrence rate were compared between the two groups.

Results: The drainage tube removal time for observation group was: <2 days: 7 cases, 2-5 days: 24 cases, > 5 days: 9 cases, and the drainage tube removal time for control group was: <2 days: 4 cases, 2-5 days: 28 cases, > 5 days, 8 cases. The incidence of intracranial gas accumulation at 1 week after surgery was 15.0% (6/40) for observation group, which was higher than control group (10%, 4/40). The incidence of postoperative complications was 5.0% (2/40) for control group and 2.5% (1/40) for observation group, but the differences were not statistically significant (P > 0.05). No recurrence was found in both groups at 1 month after surgery.

Conclusion: Based on this study, we found that enlarging the bone window exposure during CSDH surgery, repeated rinse of hematoma cavity until fluid is clear, and encouraging patients to move earlier after surgery have positive effects on the treatment outcome, but the placement depth of drainage tube has no significant impact on draining effect. It is recommended that the drainage tube should be placed within 2 cm, in order to reduce the risk of accidental entry into brain tissue and damages on subdural hematomas.

Keywords:Chronic subdural hematoma; Drainage tube; Depth; Effect

Abbreviations:CSDH: Chronic Subdural Hematoma; CT: Computerized Tomography