Value of the Application of Neuroendoscope in the Treatment of Ventriculoperitoneal Shunt Blockage.

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Value of the Application of Neuroendoscope in the Treatment of Ventriculoperitoneal Shunt Blockage.

World Neurosurg. 2018 May 10;:

Authors: Wei Q, Xu Y, Peng K, Qi S, Peng Y, Ji H, Li Y, Qiu M, Ying Y, Qiu X

Abstract
OBJECTIVE: To explore the value of the application of neuroendoscope techniques in the treatment of ventriculoperitoneal shunt blockage.
METHODS: Our study included 3 plans for revision surgeries for ventriculoperitoneal shunt blockage. In Plan A, the choroid plexus or ependyma that grew inside the ventricular catheter was completely removed. In Plan B, the terminal part of the ventricular catheter was clipped and removed. In Plan C, the ventricular catheter was carefully extracted with the assistance of neuroendoscope, and the tissues that blocked the catheter were removed. Then, the ventricular catheter was reinserted into the lateral ventricle.
RESULTS: The side holes of the tube may be blocked by cerebral tissue, granulation tissue, newly formed blood vessels, choroid plexus or ependymal. Five patients successfully underwent the Plan A revision surgery. Eight patients underwent the Plan B revision surgery. The remaining 22 patients underwent the Plan C revision surgery. After the operation, 34 patients exhibited relieved symptoms with high intracranial pressure. In all patients, the shunts became unobstructed.
CONCLUSION: Neuroendoscope techniques can be used to reveal the various causes of shunt obstruction. Any attempt to extract the tube should be performed with the assistance of neuroendoscope. There are 3 revision surgery plans for a blocked catheter. These revision surgeries for shunt obstruction are mentioned for the first time in the literature. These methods could reduce the operation time, the incidence of intraventricular hemorrhage and the risk of infection.

PMID: 29753894 [PubMed - as supplied by publisher]

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