Amini Amin, Schmidt Richard H
Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
Neurosurg Focus. 2005 Dec 15;19(6):E9.
Endoscopic third ventriculostomy (ETV) has gained popularity and has become the treatment of choice for certain pediatric and adult hydrocephalic conditions. The authors report their experience with 36 adult patients and evaluate the long-term outcome and safety of ETV. They discuss several improvements to the surgical techniques that they have developed based on their experience, including the use of intraoperative Doppler imaging before fenestration to trace the location of vessels underlying the floor of the third ventricle. They also report the use of a Rickham reservoir and endoventricular stent in selected cases and discuss the indications for their use. In cases of obstructive hydrocephalus due to congenital or acquired aqueductal stenosis in adults, the success rate of ETV in avoidance of shunt placement is 72%. Twenty-two percent of the patients in this series in whom ETV was initially successful later experienced closure of the fenestration and recurrent symptoms at a mean interval of 3.75 years. Thus, in patients who undergo this treatment, long-term periodic follow-up review should be performed.
内镜下第三脑室造瘘术（ETV）已越来越受欢迎，并已成为某些小儿和成人脑积水病症的首选治疗方法。作者报告了他们对36例成年患者的治疗经验，并评估了ETV的长期疗效和安全性。他们讨论了基于自身经验所开发的手术技术的多项改进，包括在造瘘前使用术中多普勒成像来追踪第三脑室底部下方血管的位置。他们还报告了在特定病例中使用里克姆贮液器和脑室内支架的情况，并讨论了其使用指征。在成人因先天性或后天性导水管狭窄导致梗阻性脑积水的病例中，ETV避免分流置管的成功率为72%。在该系列中，22%最初ETV治疗成功的患者后来出现造瘘口闭合和症状复发，平均间隔时间为3.75年。因此，对于接受该治疗的患者，应进行长期定期随访复查。
