在腹腔镜年龄的脑脊液伪囊的管理
Brett A Whittemore1,2, Bruno P Braga1,2, Angela V Price1,2
1Departments of1Neurosurgery and.
Journal of neurosurgery. Pediatrics
|December 15, 2023
概括
对于无菌的腹部伪囊来说,腹腔皮管突变的 laparoscopic 重新定位提供了更短的住院时间,但复发率更高. 正常的炎症标志物改善了结果,而男性性别和升高的标志物可能会增加复发风险.
科学领域:
- 神经外科 神经外科
- 儿科手术 儿科手术
- 胃肠道手术 胃肠道手术
背景情况:
- 腹腔大脑脊髓液 (CSF) 伪囊是心室关节 (VP) 短路的罕见并发症.
- 这些伪囊形成局部的腹腔内区,不好吸收CSF,可以无菌或感染.
- 有效的治疗旨在解决感染,减少炎症,并恢复腹空间中功能性CSF吸收.
研究的目的:
- 评估远端VP冲刺导管初级腹腔镜重新定位在治疗无菌腹部CSF伪囊的疗效.
- 为了比较腹腔镜重新定位与其他治疗策略的结果.
主要方法:
- 在达拉斯儿童健康 (1991-2021) 接受腹部CSF伪囊治疗的患者的回顾性审查.
- 分析患者病史和伪囊特征.
- 主要结局:1年后的伪囊复发.
主要成果:
- laparoscopic 重定位 (35/92 患者) 显示1年的分流存活率为62%,而分流拓展器/外腔室排水 (EVD) 或远管外化 (组1和2) 则为90%.
- 在腹腔镜组中,正常炎症标志物的1年生存率为100%,高标志物的47% (p=0.042).
- 腹腔镜重新定位导致住院时间显著缩短 (6天),而不是扩张/EVD (21天) (p<0.0001).
结论:
- 腹腔镜重新定位是无菌腹部CSF伪囊的可行选择,特别是在正常全身炎症标志物患者中.
- 这种方法导致住院时间更短,但可能与分流探索相比,复发率更高.
- 诸如男性性别和炎症标志物升高等因素可能与复发风险增加有关.
关键词:
在腹部的CSF伪囊.远距离分流系统的故障头部液压 (Hydrocephalus) 是一种腹腔镜重新定位 腹腔镜重新定位突变感染是突变感染.腹腔经皮关节 (ventriculoperitoneal shunt) 发生故障更多相关视频
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