Lasers in surgery and medicine · 2004
Laser-assisted endoscopic third ventriculostomy for obstructive hydrocephalus: technique and results in a series of 40 consecutive cases.
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Devaux Bertrand C, Joly Luc-Marie, Page Philippe, Nataf François, Turak Baris, Beuvon Frederic, Trystram Denis, Roux François-Xavier
Аннотация
BACKGROUND AND OBJECTIVES: To report a case series of endoscopic third ventriculostomy (ETV) using laser in 40 consecutive patients with obstructive hydrocephalus.
STUDY DESIGN/MATERIALS AND METHODS: Under stereotactic and endoscopic guidance, multiple perforations in the ventricular floor using a 1.32 microm neodymium-yttrium/aluminum/garnet (Nd-YAG) or a 0.805 microm diode laser unit and removal of intervening coagulated tissue ensued with a 4-6 mm opening between third ventricle and basilar cisterns.
RESULTS: The procedure could be completed in all cases. A transient complication occurred in five cases. In 39 patients (mean follow-up 28 months), 31 (79%) had a favorable outcome. Failure occurred in six patients, requiring permanent shunting leading to complete recovery, and two patients remained in a poor clinical status despite ETV.
CONCLUSIONS: Laser-assisted ETV is a safe and efficient procedure for the treatment of obstructive hydrocephalus. Laser is advantageous in cases of distorted anatomy and may reduce technical failures.
STUDY DESIGN/MATERIALS AND METHODS: Under stereotactic and endoscopic guidance, multiple perforations in the ventricular floor using a 1.32 microm neodymium-yttrium/aluminum/garnet (Nd-YAG) or a 0.805 microm diode laser unit and removal of intervening coagulated tissue ensued with a 4-6 mm opening between third ventricle and basilar cisterns.
RESULTS: The procedure could be completed in all cases. A transient complication occurred in five cases. In 39 patients (mean follow-up 28 months), 31 (79%) had a favorable outcome. Failure occurred in six patients, requiring permanent shunting leading to complete recovery, and two patients remained in a poor clinical status despite ETV.
CONCLUSIONS: Laser-assisted ETV is a safe and efficient procedure for the treatment of obstructive hydrocephalus. Laser is advantageous in cases of distorted anatomy and may reduce technical failures.