World neurosurgery · 2024
Electromagnetic Navigation Improves Accuracy and Reduces Complications of Ventriculoperitoneal Shunts in Patients with Idiopathic Normal Pressure Hydrocephalus: A Single-Center Clinical Experience.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ma Xudong, Fan Xuehai, Yang Wenqinyi, Guo Jiahe, Zhou Ziwei, Wang Dong, Wu Yimeng, Zhang Ningnannan, Song Guozhi, Xing Yan, Liu Xiuyun, Yu Kai, Yu Huijie
Аннотация
BACKGROUND: Ventriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compared the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in patients with iNPH, focusing on catheter accuracy and postoperative complication rates.
METHODS: This retrospective study included 31 patients with iNPH who underwent standard shunt placement using anatomical landmarks and 50 patients who underwent EM-guided shunt placement. Parameters assessed included shunt placement grade, catheter tip position, catheter angle, puncture attempts, operative duration, postoperative infection rates, intraparenchymal hemorrhage rates, and shunt malfunction rates. Patients had follow-ups at 3, 6, 12, and 24 months after surgery or until shunt failure.
RESULTS: In the EM-guided group, a higher percentage of grade 1 shunt placements (92% vs. 71%, P = 0.03) and fewer grade 3 placements (2% vs. 13%, P = 0.068) were observed. The catheter tip position at the foramen of Monro was significantly more accurate (P < 0.001), with smaller lateral catheter deviation angles in both coronal (19.69° vs. 24.2°, P < 0.0001) and sagittal (21.75° vs. 39.3°, P < 0.01) sections. The EM-guided group had fewer puncture attempts, shorter operative durations, lower incidence of intraparenchymal hemorrhage (P < 0.01), and fewer shunt malfunctions over the 2-year follow-up period (2% vs. 26%, P = 0.0003).
CONCLUSIONS: The use of EM navigation in VP shunt placement for patients with iNPH improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.
METHODS: This retrospective study included 31 patients with iNPH who underwent standard shunt placement using anatomical landmarks and 50 patients who underwent EM-guided shunt placement. Parameters assessed included shunt placement grade, catheter tip position, catheter angle, puncture attempts, operative duration, postoperative infection rates, intraparenchymal hemorrhage rates, and shunt malfunction rates. Patients had follow-ups at 3, 6, 12, and 24 months after surgery or until shunt failure.
RESULTS: In the EM-guided group, a higher percentage of grade 1 shunt placements (92% vs. 71%, P = 0.03) and fewer grade 3 placements (2% vs. 13%, P = 0.068) were observed. The catheter tip position at the foramen of Monro was significantly more accurate (P < 0.001), with smaller lateral catheter deviation angles in both coronal (19.69° vs. 24.2°, P < 0.0001) and sagittal (21.75° vs. 39.3°, P < 0.01) sections. The EM-guided group had fewer puncture attempts, shorter operative durations, lower incidence of intraparenchymal hemorrhage (P < 0.01), and fewer shunt malfunctions over the 2-year follow-up period (2% vs. 26%, P = 0.0003).
CONCLUSIONS: The use of EM navigation in VP shunt placement for patients with iNPH improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.