{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:10Z","timestamp":1786125070603,"version":"build-2736575974"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Postoperative cerebrospinal fluid (CSF) leak is a persistent, albeit much less prominent, complication following endonasal endoscopic surgery. The pathology with highest risk is suprasellar meningiomas. A postoperative lumbar drain (LD) is used to decrease the risk of CSF leak but is not universally accepted.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To compare the rates of postoperative CSF leak between patients with and without LD who underwent endonasal endoscopic surgical resection of suprasellar meningiomas.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A consecutive series of newly diagnosed suprasellar meningiomas was drawn from a prospectively acquired database of endonasal endoscopic surgeries at our institution. An intraoperative, preresection LD was placed and left open at 5 cc\/h for \u223c48 h. In a subset of patients, the LD could not be placed. Rates of postoperative CSF leak were compared between patients with and without an LD.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Twenty-five patients underwent endonasal endoscopic surgical resection of suprasellar meningiomas. An LD could not be placed in 2 patients. There were 2 postoperative CSF leaks (8%), both of which occurred in the patients who did not have an LD (\n P =<\/jats:italic>\n .0033). The average body mass index (BMI) of the patients in whom the LD could not be placed was 39.1 kg\/m\n 2<\/jats:sup>\n , compared with 27.6 kg\/m\n 2<\/jats:sup>\n for those in whom the LD could be placed (\n P<\/jats:italic>\n = .009). In the subgroup of obese patients (BMI > 30 kg\/m\n 2<\/jats:sup>\n ), LD placement was protective against postoperative CSF leak (\n P<\/jats:italic>\n = .022).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n The inability to place an LD in patients with obesity is a risk factor for postoperative CSF leak.\u00a0An LD may be useful to prevent postoperative CSF leak, particularly in patients with elevated BMI.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ons\/opx070","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T23:05:13Z","timestamp":1491433513000},"page":"66-71","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":46,"title":["Lumbar Drains Decrease the Risk of Postoperative Cerebrospinal Fluid Leak Following Endonasal Endoscopic Surgery for Suprasellar Meningiomas in Patients With High Body Mass Index"],"prefix":"10.1227","volume":"14","author":[{"given":"Salomon","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Weill Cor-nell Medical College, New York Presbyte-rian Hospital, New York, New York"},{"name":"Depart-ment of Neurosurgery, National Institute of Neurology and Neurosurgery \u201cManuel Velasco Suarez,\u201d Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel H","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cor-nell Medical College, New York Presbyte-rian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivashanmugam","family":"Dhandapani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cor-nell Medical College, New York Presbyte-rian Hospital, New York, New York"},{"name":"De-partment of Neurosurgery, Post Graduate Institute of Medical Education and Re-search (PGIMER), Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem M","family":"Negm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cor-nell Medical College, New York Presbyte-rian Hospital, New York, New York"},{"name":"De-partment of Neurosurgery, Menoufia Uni-versity, Shebeen El Kom, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K","family":"Anand","sequence":"additional","affiliation":[{"name":"De-partment of Otolaryngology, Weill Cor-nell Medical College, New York Presby-terian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cor-nell Medical College, New York Presbyte-rian Hospital, New York, New York"},{"name":"De-partment of Otolaryngology, Weill Cor-nell Medical College, New York Presby-terian Hospital, New York, New York"},{"name":"De-partment of Neuroscience, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,1]]},"reference":[{"issue":"1","key":"bib1-20240910","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1227\/01.NEU.0000316852.01820.45","article-title":"Endscopic endonasal resection of anterior cranial base meningiomas","volume":"63","author":"Gardner","year":"2008","journal-title":"Neurosurgery"},{"issue":"1","key":"bib2-20240910","first-page":"1","article-title":"Evolution of reconstructive techniques following endoscopic expanded endonasal approaches","volume":"19","author":"Kassam","year":"2005","journal-title":"Neurosurg Focus"},{"issue":"6","key":"bib3-20240910","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1055\/s-0030-1253573","article-title":"How to choose? 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