Journal of Korean Neurosurgical Society

  • 제53권3호
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  • Pages.150-154
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  • 2013
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Effect of Electromagnetic Navigated Ventriculoperitoneal Shunt Placement on Failure Rates

  • Jung, Nayoung (Department of Neurosurgery, Dongsan Medical Center, Keimyung University College of Medicine) ;
  • Kim, Dongwon (Department of Neurosurgery, Dongsan Medical Center, Keimyung University College of Medicine)
  • 투고 : 2012.08.03
  • 심사 : 2013.02.25
  • 발행 : 2013.03.28
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초록

Objective : To evaluate the effect of electromagnetic (EM) navigation system on ventriculoperitoneal (VP) shunt failure rate through comparing the result of standard shunt placement. Methods : All patients undergoing VP shunt from October 2007 to September 2010 were included in this retrospective study. The first group received shunt surgery using EM navigation. The second group had catheters inserted using manual method with anatomical landmark. The relationship between proximal catheter position and shunt revision rate was evaluated using postoperative computed tomography by a 3-point scale. 1) Grade I; optimal position free-floating in cerebrospinal fluid, 2) Grade II; touching choroid or ventricular wall, 3) Grade III; tip within parenchyma. Results : A total of 72 patients were participated, 27 with EM navigated shunts and 45 with standard shunts. Grade I was found in 25 patients from group 1 and 32 patients from group 2. Only 2 patients without use of navigation belonged to grade III. Proximal obstruction took place 7% in grade I, 15% in grade II and 100% in grade III. Shunt revision occurred in 11% of group 1 and 31% of group 2. Compared in terms of proximal catheter position, there was growing trend of revision rate according to increase of grade on each group. Although infection rate was similar between both groups, the result had no statistical meaning (p=0.905, chi-square test). Conclusion : The use of EM navigation in routine shunt surgery can eliminate poor shunt placement resulting in a dramatic reduction in failure rates.

키워드

참고문헌

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  1. Image Guidance in Ventricular Cerebrospinal Fluid Shunt Catheter Placement vol.77, pp.3, 2015, https://doi.org/10.1227/neu.0000000000000849
  2. EVALUATION OF VENTRICULOPERITONEAL SHUNT SURGERY THROUGH CONVENTIONAL AND VENTRICULOSCOPIC TECHNIQUE vol.6, pp.2, 2013, https://doi.org/10.14260/jemds/2017/33
  3. Adjustable Ghajar Guide Technique for Accurate Placement of Ventricular Catheters : A Pilot Study vol.60, pp.5, 2017, https://doi.org/10.3340/jkns.2016.1011.004
  4. Yield of early postoperative computed tomography after frontal ventriculoperitoneal shunt placement vol.13, pp.6, 2013, https://doi.org/10.1371/journal.pone.0198752
  5. GAVCA Study: Randomized, Multicenter Trial to Evaluate the Quality of Ventricular Catheter Placement with a Mobile Health Assisted Guidance Technique vol.83, pp.2, 2018, https://doi.org/10.1093/neuros/nyx420
  6. Image Guidance for Ventricular Shunt Surgery: An Analysis of Hospital Charges vol.85, pp.4, 2013, https://doi.org/10.1093/neuros/nyz090
  7. Current Update on Treatment Strategies for Idiopathic Normal Pressure Hydrocephalus vol.21, pp.12, 2019, https://doi.org/10.1007/s11940-019-0604-z
  8. Techniques and Nuances in Ventriculoperitoneal Shunt Surgery vol.69, pp.8, 2013, https://doi.org/10.4103/0028-3886.332261