METHODS: A total of 159 patients were included in the study. One hundred and twenty-three patients received a ventriculoperitoneal shunt, whereas 36 patients were treated with an endoscopic procedure. Only patients with a postoperative observation period of at least 3 years were included in the analyses of the long-term data. In addition to general patient and operation data, the number and frequency of perioperative complications (infections, dysfunctions) and the frequency and type of necessary revision operations were collected.
RESULTS: The average observation period was 69 months for both groups. The risk of operative revision was significantly elevated in the shunt group despite a comparable observation period. Whereas 86.11% of the endoscopy group did not require an operative revision, that only applied to 68.85% of the shunt group. The complication rate was 42.7% in the shunt group per procedure, which was clearly higher than in the endoscopy group at only 9.4%.
CONCLUSIONS: The risk of operative revision and/or complications is significantly lower in the endoscopic ventriculocisternostomy group compared to the ventriculoperitoneal shunt group. Given the appropriate indication, endoscopic ventriculocisternostomy is thus the treatment of choice.
方法:本研究共纳入159例患者。一百二十三名病人接受了脑室-腹腔分流术,而36例患者接受了内镜手术治疗。仅将术后观察期至少为3年的患者纳入长期数据分析。除了一般的病人和手术数据,围手术期并发症的数量和频率(感染,功能障碍)以及收集必要的修订操作的频率和类型。
结果:两组平均观察期为69个月。尽管观察时间相当,但分流组手术翻修的风险显着升高。而内窥镜检查组的86.11%不需要手术翻修,仅适用于分流组的68.85%。分流组每次手术并发症发生率为42.7%,明显高于内窥镜检查组的9.4%。
结论:与脑室腹腔分流术组相比,内镜下脑室造口术组手术翻修和/或并发症的风险显著降低。如果有适当的指示,因此,内镜下脑室腹水造口术是治疗的首选方法。