作为局部脑积水,捕获的颞角(TTH)可以通过脑脊液分流有效解决。除了常规的脑室-腹腔分流术(VPS),颞角分流术(TFHS)已被描述为一个不太复杂和侵入性的程序,有希望的结果;然而,比较VPS和TFHS患者结局的数据有限.本研究旨在比较TFHS与VPS治疗TTH的疗效。我们在2012年至2021年期间对接受TTH治疗的患者进行了一项比较队列研究。主要结果是30天的翻修率,6个月,和1年。次要结果包括手术持续时间,术后疼痛,住院,过排水,以及分流器放置和修改的成本。共包括24名患者,13例(54.2%)患者接受TFHS,11例(45.8%)患者接受VPS。两个队列共享相似的基线特征。在30天内,TFHS和VPS之间没有显着差异(7.7%vs9.1%,p>0.99),6个月(7.7%对18.2%,p=0.576),或1年期(8.3%对18.2%,p=0.590)修订率。手术时间没有显着差异(93.5±24.1vs90.5±29.6分钟,p=0.744),手术部位疼痛(0vs18.2%,p=0.199),或术后住院时间(4.8±2.6vs6.9±4.0天,两组之间p=0.157)。对于TFHS队列,没有患者经历分流相关的过度引流,并且有减少过度排水的趋势(0%对27.3%,p=0.082)与VPS相比。与VPS相比,TFHS显着降低了初始分流的成本(¥20,417vs¥33,314,p=0.030)以及分流和修订的总成本(¥21,602vs¥43,196,p=0.006)。作为一种无阀分流技术,没有腹部切口,TFHS是化妆品,成本效益高,与VPS相比,完全没有过度排水,修订率相似。
As a localized hydrocephalus, trapped temporal horn (TTH) can be effectively resolved via cerebrospinal fluid shunting. In addition to conventional ventriculo-peritoneal
shunt (VPS), temporal-to-frontal horn
shunt (TFHS) has been described as a less complex and invasive procedure with promising results; however, there is limited data comparing VPS to TFHS regarding patient outcomes. This study aims to compare TFHS versus VPS for treatment of TTH. We conducted a comparative cohort study with patients undergoing TFHS or VPS for TTH after surgery of trigonal or peritrigonal tumors between 2012 and 2021. The primary outcome was revision rates at 30-day, 6-month, and 1-year. Secondary outcomes included operative duration, postoperative pain, hospital stay, overdrainage, and cost for
shunt placement and revision. A total of 24 patients included, with 13 (54.2%) patients receiving TFHS and 11 (45.8%) receiving VPS. Both cohorts shared similar baseline characteristics. There were no significant differences between TFHS and VPS in 30-day (7.7% vs 9.1%, p > 0.99), 6-month (7.7% vs 18.2%, p = 0.576), or 1-year (8.3% vs 18.2%, p = 0.590) revision rates. There were no significant differences in terms of operative duration (93.5 ± 24.1 vs 90.5 ± 29.6 min, p = 0.744), surgical site pain (0 vs 18.2%, p = 0.199), or postoperative length of stay (4.8 ± 2.6 vs 6.9 ± 4.0 days, p = 0.157) between the two groups. For the TFHS cohort, no patient experienced
shunt related overdrainage, and there was a trend towards fewer overdrainage (0% vs 27.3%, p = 0.082) compared with VPS. TFHS offered significant reduction in cost for initial
shunt (¥20,417 vs ¥33,314, p = 0.030) and total costs for
shunt and revision (¥21,602 vs ¥43,196, p = 0.006) compared to VPS. As a technique of valveless shunt and without abdominal incision, TFHS is cosmetic, cost-effective, and completely free of overdrainage with similar revision rates as compared with VPS.