Devaux Bertrand C, Joly Luc-Marie, Page Philippe, Nataf François, Turak Baris, Beuvon Frederic, Trystram Denis, Roux François-Xavier
Department of Neurosurgery, Centre Hospitalier Sainte-Anne, rue Cabanis, 75674, Paris cedex 14, France.
Lasers Surg Med. 2004;34(5):368-78. doi: 10.1002/lsm.20045.
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.
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.
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.
报告40例连续性梗阻性脑积水患者接受内镜下第三脑室造瘘术（ETV）并使用激光的病例系列。
研究设计/材料与方法：在立体定向和内镜引导下，使用1.32微米钕钇铝石榴石（Nd-YAG）激光或0.805微米二极管激光装置在脑室底部进行多处穿孔，随后切除中间的凝固组织，在第三脑室和基底池之间形成4-6毫米的开口。
所有病例手术均能完成。5例出现短暂并发症。39例患者（平均随访28个月）中，31例（79%）预后良好。6例患者手术失败，需永久性分流并完全康复，2例患者尽管接受了ETV，但临床状态仍较差。
激光辅助ETV是治疗梗阻性脑积水的一种安全有效的方法。激光在解剖结构扭曲的病例中具有优势，可能减少技术失败。
