| Efficacy of Laparoscopcially Assisted Ventriculo-Peritoneal Shunt in Elderly Patients |
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Seong Hun Lee , Joon Suk Song , Jae Hun Cha , Seong Woon Lee , Ho Soo Kim |
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Department of Neurosurgery, Wallace Memorial Baptist Hospital, Busan, Korea |
| 노인 수두증 환자에게서 복강경을 이용한 뇌실 복강 단락술의 효용성 |
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이성훈ㆍ송준석ㆍ차재훈ㆍ이성운ㆍ김호수 |
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왈레스기념 침례병원 신경외과 |
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| Abstract |
Objective
Ventriculo-peritoneal shunt procedure has been widely used for the treatment of hydrocephalus. Traditional ventriculo-peritoneal shunt procedure involves the insertion of the distal catheter by laparotomy. However, common complications of laparotomy are infection and shunt obstruction, which is related to the distal shunt catheter. We reviewed the indications, techniques, wound healing time, postoperative complications such as shunt infection rate and shunt catheter obstruction and analyzed the clinical outcome between laparoscopically assisted group and conventional laparotomy group in elderly patients over 60 years old.
Methods
A 78 ventriculo-peritoneal shunt procedures were performed in our hospital between May 2007 and March 2012, 50 of which were by laparoscopically assisted laparotomy and 28 were by conventional laparotomy. Cases of distal catheter reposition were excluded. Ten of 78 patients had the history of an abdominal surgery in advance.
Results
Distal catheter obstruction rate was significantly lower in the laparoscopically assisted laparotomy group (1 case, 2%) than the conventional laparotomy group (5 cases, 17.9%, p<0.05). And shunt infections occurred in 2 cases (4%) and 4 cases (14.3%) in the laparoscopically assisted group and in the laparotomy group, respectively. The mean time of wound healing was slightly shorter in the laparotomy group (9.9 days) than in the laparoscopically assisted group (10.2 days).
Conclusion
The laparoscopically assisted placement of the ventriculo-peritoneal shunt catheter in elderly patients reduces distal catheter malfunction, compared with conventional laparotomy. |
| Key Words:
HydrocephalusㆍVentriculo-peritoneal shuntㆍLaparoscopyㆍComplication |
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