JIANG Feng,ZHAO Yang,SUN Liang ping,et al.Endoscopic third ventricul ostomy versus ventricul operitoneal shunt:clinical study of obstructive hydro cephalus in infants.[J].Journal of Clinical Pediatric Surgery,,10():0.
Endoscopic third ventricul ostomy versus ventricul operitoneal shunt:clinical study of obstructive hydro cephalus in infants.
- Keywords:
- Hydrocephalus; Surgical procedures; Operative; Infant
- Abstract:
- ObjectiveWe analyzed those infant patients with obstructive hydrocephalus since 2005 in our department. The postoperative outcome was compared by followup data such as images and clinical finding. Methods 36 subjects were included in the study, and divided as ETV group and VP shunt group depend on the surgical procedure. We retrospectively analyzed the followup data such as images and clinical finding of the obstructive patients younger than 2 years old in our department since 2005, and compare the successful rate and complication rate.Results Among 36 patients, 20 of them were treated with ETV and 16 of them were treated with VP shunt. In ETV group, 1 infant did not get improved and suffered from CSF leakage after operation, and VP shunt was performed to avoid intracranial infection. Intraventricular hemorrhage occurred in 1 and was treated with medicine. 1 child presented with subdural hemotoma and recovered. 2 children had seizure after surgery was treated with medicine without recurrence. The complications were transient and mostly recovered, no late complication. No severe complication occurred. The early complication rate was 25% in ETV group and successful rate was 95%. In VP shunt group, 1 child presented with incranial infection, the ventricular catheter was removed to treat the infection. VP shunt was performed again after the infection was controlled. 1 case did not improve and performed ETV to control the hydrocephalus. 1 case presented with shunt malfunction and was treated with repeated VP shunt one year after the first surgery. 1 case suffered from the ventricular catheter migration and was treated with the repeated VP shunt 1 year after operation. In VP shunt group, the overall successful rate was 75%, the complication rate was 25%. Among them, the early complication rate was 6.25% , the late complication rate was 18.75%, all the complications need surgery precedure. Conclusions It could be concluded that ETV is the most often performed and reported neuroendoscopic procedure in the treatment of hydrocephalus caused by pure aqueductal stenosis. Compare to VP shunt group,ETV group had no mortaliity, lower failure rate, higher early complication rate but transient and mild. No more neurologic defect occured by followup in ETV group. In this group of infants, ETV is a significant alternative to ventricular shunt placement.
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Memo
作者单位：上海交通大学医学院附属新华医院小儿神经外科（200092）,通讯作者： 马杰，Email:majie365@hotmail.com