内镜下第三脑室造瘘术在2岁以下患者中的疗效和成功率

M. Ertaş, Derya Karaoğlu Gündoğdu, Mert Şahinoğlu, Ender Köktekir, H. Karabağlı
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摘要

目的:内镜下第三脑室造口术(ETV)是治疗无分流脑积水的重要选择。由于内窥镜系统的最新技术发展,第三脑室造口术(ETV)越来越受欢迎。但是医生的冲动,为他的病人提供一个无分流的生存,导致在一个不合适的病人群体中进行手术。与分流手术相比,ETV为脑积水的治疗提供了一种更生理的解决方案。在许多中心,在适当的病例中,ETV被接受为治疗梗阻性脑积水的一线治疗方法。本研究的目的是检查两岁以下患者进行内窥镜第三脑室造口术的结果。方法:回顾性分析2011年至2020年在我院行ETV手术的79例患者,手术时年龄在2岁以下。结果:79例患儿中男婴45例,女婴34例。患者平均年龄为7个月(1天- 22个月)。39例(49.3%)患者在ETV术后随访中无需再次手术。5例(6.3%)患者重复行ETV手术,2例(2.5%)患者行腹腹腔分流术(VPS)手术。在13例患者中,脑室-腹膜分流术从前部应用,并出现分流功能障碍。13例患者中有3例(23%)在ETV术后未再行VPS手术。结论:ETV也可以应用于2岁以下的患者,这种治疗方法可以使患者有机会过上不依赖分流的生活。
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Effectiveness and success rates of endoscopic third ventriculostomy in patients under 2 years old
Objective: Endoscopic third ventriculostomy (ETV) stands out as an important option in the treatment of hydrocephalus without shunts. Endoscopic third ventriculostomy (ETV) has become more popular due to recent technical developments in endoscopic systems. But the urge of the physician, to provide a shuntfree survival for his patients, leads to performing the procedure in a unsuitable group of patients. Compared with shunt surgery, ETV presents a more physiological solution for the treatment of hydrocephalus. ETV is accepted as the first-line treatment method in many centers in appropriate cases in the treatment of obstructive hydrocephalus. The aim of this study is to examine the results of patients under the age of two underwent endoscopic third ventriculostomy. Methods: 79 patients who underwent ETV between 2011 and 2020 in our clinic and who were under 2 years of age at the time of operation were retrospectively analyzed. Results: 45 of 79 patients were male babies and 34 were female babies. The average age of the patients is 7 months (1 day - 22 months). In 39 (49.3%) patients, there was no need for repeat surgery in their follow-up after ETV. ETV procedure was repeated in 5 (6.3%) patients, and ventriluloperitoneal shunt (VPS) surgery was performed in 2 (2.5%) patients. In 13 patients, ventriculoperitoneal shunt was applied from the anterior and presented with shunt dysfunction. VPS surgery was not performed again after ETV in 3 (23%) of 13 patients after ETV. Conclusions: ETV can also be applied to patients younger than two years of age, and this treatment can give patients the chance to live a life independent of shunt.
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