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Erschienen in: Child's Nervous System 3/2019

12.01.2019 | Original Article

Treatment of multi-loculated hydrocephalus using endoscopic cyst fenestration and endoscopic guided VP shunt insertion

verfasst von: Sirachai Piyachon, Nunthasiri Wittayanakorn, Lisa Kittisangvara, Paveen Tadadontip

Erschienen in: Child's Nervous System | Ausgabe 3/2019

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Abstract

Objective

To evaluate the role of endoscopic cyst fenestration and endoscopic guided VP shunt insertion in multi-loculated hydrocephalus in children.

Method

A retrospective analysis was performed on 20 patients with multi-loculated hydrocephalus who underwent endoscopic cyst fenestration (ECF) alone or in combination with VP shunt revision or insertion between August 2014 and December 2016 with the extended follow-up period to December 2017.

Results

Thirty-one ECFs were performed: ECF alone, 10 operations in 8 cases, and 21 ECFs with shunt insertion in 12 cases. Eighteen of 20 patients required a VP shunt, 7 cases required multiple shunts. All patients with a previous shunt remained shunt dependent; and 6 cases with no prior shunt underwent endoscopic guided ventricular catheter insertion after ECF; only 2 cases did not require a shunt after ECF. The rate of repeated ECFs was 0.25 operations/year and the shunt revision rate was 0.11 operations/year. VP shunt or cystoperitoneal shunt without repeat ECF was used in 7 cases (35%). Mean duration between operations was 71 days in repeated ECF and 16 days in added-on shunt. The most common cause of re-operations was new formation of intraventricular fibrosis or compartmentalization causing ventricular catheter blockage.

Conclusion

Endoscopic cyst fenestration and endoscopic assisted VP shunt insertion minimize shunt complications in multi-loculated hydrocephalus. Shunt independence is unusual.
Fußnoten
1
Acetar solution is an isotonic solution that contains Na 130 mEq/L, K 4 mEq/L, Cl 108.7 mEq/L, acetate 28 mEq/L, and osmolarity 273.4 mOsm/L. Acetate in this solution will be changed to bicarbonate in the muscle so it is widely used in patients with liver impairment.
 
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Metadaten
Titel
Treatment of multi-loculated hydrocephalus using endoscopic cyst fenestration and endoscopic guided VP shunt insertion
verfasst von
Sirachai Piyachon
Nunthasiri Wittayanakorn
Lisa Kittisangvara
Paveen Tadadontip
Publikationsdatum
12.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 3/2019
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-019-04047-w

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