Abstract：
Inserting cerebrospinal fluid diversion devices such as external ventricular drains (EVDs) and ventriculoperitoneal shunts (VPSs) is a critical procedure. Unfortunately, complications such as catheter misplacement, dislocation, or infection can occur. Various surgical strategies aim to reduce these risks. One recent innovation is the \"catheter-locking device-assisted\" technique for EVD surgery. In this study, we examined its application in a larger group of cases encompassing both EVDs and VPSs over a 30-month period, with a focus on these complications.
All adult patients who underwent a shunt procedure for noninfectious hydrocephalus at our institution from January 2021 to June 2023 were reviewed. We compared complications between those treated with the \"standard\" technique (subgroup A) and those managed with the \"catheter-locking device-assisted\" approach (subgroup B).
In the EVD surgical group (initial procedures, n = 161), 6 patients (3.7%) required reoperation owing to the catheter misplacement caused by inadvertent migration of the ventricular catheter within the operating room (\"early\" migration), while 11 patients (6.8%) experienced unintentional postoperative dislodgement (\"delayed\" migration). Seven patients (4.3%) developed an EVD-related infection after an average duration of 7.4 days. None of these complications were observed in subgroup B patients (P < 0.05). Among VPS patients (n = 137), 4 (2.9%), all in subgroup A, required reoperation due to intraoperative migration of the catheter (P = 0.121); no other complications were identified.
The \"catheter-locking device-assisted\" technique may significantly decrease the occurrence of the most common EVD complications and can also prove beneficial in VPS surgery. However, further investigation is necessary.
All adult patients who underwent a shunt procedure for noninfectious hydrocephalus at our institution from January 2021 to June 2023 were reviewed. We compared complications between those treated with the \"standard\" technique (subgroup A) and those managed with the \"catheter-locking device-assisted\" approach (subgroup B).
In the EVD surgical group (initial procedures, n = 161), 6 patients (3.7%) required reoperation owing to the catheter misplacement caused by inadvertent migration of the ventricular catheter within the operating room (\"early\" migration), while 11 patients (6.8%) experienced unintentional postoperative dislodgement (\"delayed\" migration). Seven patients (4.3%) developed an EVD-related infection after an average duration of 7.4 days. None of these complications were observed in subgroup B patients (P < 0.05). Among VPS patients (n = 137), 4 (2.9%), all in subgroup A, required reoperation due to intraoperative migration of the catheter (P = 0.121); no other complications were identified.
The \"catheter-locking device-assisted\" technique may significantly decrease the occurrence of the most common EVD complications and can also prove beneficial in VPS surgery. However, further investigation is necessary.
摘要：
背景：插入外部心室引流（EVD）和脑室腹膜分流（VPS）等脑脊液改道装置是一项关键程序。不幸的是,并发症，如导管错位，位错,或感染可能发生。各种手术策略旨在降低这些风险。最近的一项创新是用于EVD手术的“导管锁定装置（CLD）辅助”技术。在这项研究中,我们在30个月的时间内检查了其在更大的一组病例中的应用，包括EVD和VPS，重点关注这些并发症。
方法：对2021年1月至2023年6月在我院接受非感染性脑积水分流手术的所有成年患者进行了回顾。我们比较了使用“标准”技术治疗的患者（A亚组）和使用“CLD辅助”方法治疗的患者（B亚组）的并发症。
结果：在EVD手术组（初始程序，n=161),6例患者（3.7%）由于心室导管在手术室内的意外移动（“早期”移动）导致导管错位而需要再次手术，而11例患者（6.8％）经历了意外的术后移位（“延迟”迁移）。7名患者（4.3％）在平均7.4天后发展为EVD相关感染。在B亚组患者中没有观察到这些并发症（p<0.05）。在VPS患者中（n=137），4（2.9%），都在亚组A中，术中导管移位需要再次手术(p=.121);未发现其他并发症.
结论：“CLD辅助”技术可以显着减少最常见的EVD并发症的发生，并且还可以证明对VPS手术有益。然而,需要进一步调查。
方法：对2021年1月至2023年6月在我院接受非感染性脑积水分流手术的所有成年患者进行了回顾。我们比较了使用“标准”技术治疗的患者（A亚组）和使用“CLD辅助”方法治疗的患者（B亚组）的并发症。
结果：在EVD手术组（初始程序，n=161),6例患者（3.7%）由于心室导管在手术室内的意外移动（“早期”移动）导致导管错位而需要再次手术，而11例患者（6.8％）经历了意外的术后移位（“延迟”迁移）。7名患者（4.3％）在平均7.4天后发展为EVD相关感染。在B亚组患者中没有观察到这些并发症（p<0.05）。在VPS患者中（n=137），4（2.9%），都在亚组A中，术中导管移位需要再次手术(p=.121);未发现其他并发症.
结论：“CLD辅助”技术可以显着减少最常见的EVD并发症的发生，并且还可以证明对VPS手术有益。然而,需要进一步调查。
