Aprianto Dirga Rachmad, Parenrengi Muhammad Arifin, Utomo Budi, Al Fauzi Asra, Subagio Eko Agus, Suryawan Ahmad
Department of Neurosurgery, Dr. Soetomo General Academic Hospital.
Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga.
Surg Neurol Int. 2022 Sep 9;13:406. doi: 10.25259/SNI_1204_2021. eCollection 2022.
Cranioplasty in pediatrics is quite challenging and intricated. The ideal material for it is still debatable until now due to the limited study comparing autologous and implant grafts. This meta-analytic study was conducted to evaluate the risk of infection and revision in pediatric patients after autograft and implant cranioplasty.
A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A thorough literature search was conducted on PubMed, Cochrane, Scopus, and ScienceDirect database. Articles published from 2000 to 2021 were selected systematically using PRISMA based on the predetermined eligibility criteria. The relevant data were, then, analyzed and discussed.
A total of four publications investigating the outcome of autograft and implant cranioplasty were included and reviewed. Postoperative infection and revision rate after 126 cranioplasty procedures (both autograft or implant) from 119 patients below 21 years during time frame of study were analyzed. This meta-analysis study showed that the rate of infection and revision after cranioplasty were not different between the autograft and implant groups.
Autograft and implant cranioplasty have no significant difference in postoperatively infection and revision rate. This study showed that cranioplasty using implant is a plausible option in pediatric patients with cranial defects, depending on the patients' condition due to similar outcome with autograft cranioplasty. Further studies with larger population and more specific details are necessary to determine the comparison of autograft and implant material in cranioplasty procedure.
小儿颅骨成形术极具挑战性且复杂。由于比较自体移植和植入物移植的研究有限，迄今为止，其理想材料仍存在争议。本荟萃分析研究旨在评估小儿患者自体移植和植入物颅骨成形术后的感染风险和翻修情况。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价和荟萃分析。在PubMed、Cochrane、Scopus和ScienceDirect数据库上进行了全面的文献检索。根据预先确定的纳入标准，使用PRISMA系统筛选2000年至2021年发表的文章。然后，对相关数据进行分析和讨论。
共纳入并回顾了四项研究自体移植和植入物颅骨成形术结果的出版物。分析了研究期间119例21岁以下患者126次颅骨成形术（包括自体移植或植入物）后的术后感染率和翻修率。本荟萃分析研究表明，自体移植组和植入物组颅骨成形术后的感染率和翻修率无差异。
自体移植和植入物颅骨成形术在术后感染率和翻修率方面无显著差异。本研究表明，对于有颅骨缺损的小儿患者，使用植入物进行颅骨成形术是一个可行的选择，这取决于患者的具体情况，因为其结果与自体移植颅骨成形术相似。需要进行更大规模、更详细的进一步研究，以确定颅骨成形术中自体移植和植入物材料的比较。
