Jiang Shu, Mao Bo-yong, Zhou Zong-guang, Du Jing-ping, Shu Ye, Cheng Yong-zhong
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2004 Jan;35(1):123-5.
To compare the clinical effectiveness of ventriculoperitoneal shunt (VPS) assisted by laparoscope versus the clinical effectiveness of VPS via traditional laparotomy in treating hydrocephalus.
The clinical data on 26 cases of VPS with laparoscope assistance and on 234 cases of VPS via traditional laparotomy were summerized and analyzed retrospectively. The operation efficacy and the complication rate were compared between the two groups.
In the traditional laparotomy group, there were 6 cases of peritoneal catheter obstruction or displacement, 5 cases of postoperative infection, and 2 childhood cases where the peritoneal catheter made a way into the rectum and through the anus. But in the laparoscope group, there was only one case of postoperative infection. Postoperatively the laparoscope group was better than the traditional laparotomy group in respect to the postoperative outcome, complication rate and the clinical improvement. Thirteen cases were treated by the VPS using right liver-diaphragm interspace drainage and another 13 cases were treated by the VPS using pelvis cavity drainage in the laparoscope group, respectively.
The technique of VPS assisted by laparoscopies safe, reliable, and has the advantages of accurate positioning, minimal injury and less postoperative complications; it is worthy of clinical application and popularization. Positioning the peritoneal catheter to the liver-diaphragm interspace can avoid the complications caused by perforation of the cavity organs.
比较腹腔镜辅助脑室腹腔分流术(VPS)与传统开腹VPS治疗脑积水的临床疗效。
回顾性总结分析26例腹腔镜辅助VPS及234例传统开腹VPS的临床资料,比较两组手术疗效及并发症发生率。
传统开腹组发生腹膜导管堵塞或移位6例,术后感染5例,小儿患者腹膜导管经直肠由肛门穿出2例;而腹腔镜组仅发生术后感染1例。术后腹腔镜组在术后转归、并发症发生率及临床改善情况方面均优于传统开腹组。腹腔镜组中13例采用VPS右肝膈间隙引流,另13例采用盆腔引流。
腹腔镜辅助VPS技术安全可靠,具有定位准确、损伤小、术后并发症少等优点,值得临床应用推广。将腹膜导管置于肝膈间隙可避免腹腔脏器穿孔所致并发症。