Greenfield Jeffrey P, Schwartz Theodore H
Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10021, USA.
Stereotact Funct Neurosurg. 2008;86(2):101-5. doi: 10.1159/000112431. Epub 2007 Dec 12.
Infusion of intraventricular chemotherapy requires precise ventricular catheter placement in oncology patients to avoid intraparenchymal infusion. We assessed the safety and precision of using frameless surgical navigation for the placement of Ommaya reservoir catheters.
In 20 consecutive patients who required Ommaya reservoirs for the administration of intrathecal chemotherapy, the catheters were positioned with the guidance of frameless stereotaxy. Precision of catheter placement, operative time, operative complications, and postoperative complications were assessed.
All catheters were completely within cerebrospinal fluid and 90% were within 5 mm of the intended target, the ipsilateral foramen of Monro. The average operative time was 47 min, and there were no intraoperative complications. There were no reports of leukoencephalopathy, and 3 patients had minor delayed complications.
Frameless surgical navigation is a useful and efficient method for ensuring accurate catheter placement during Ommaya reservoir implantation, and it reduces the risk of potential parenchymal toxicity.
在肿瘤患者中进行脑室内化疗时,需要精确放置脑室导管以避免脑实质内注射。我们评估了使用无框架手术导航放置奥马亚贮液器导管的安全性和精确性。
在20例需要奥马亚贮液器进行鞘内化疗的连续患者中,在无框架立体定向引导下放置导管。评估导管放置的精确性、手术时间、手术并发症和术后并发症。
所有导管均完全位于脑脊液内,90%位于预期靶点(同侧室间孔)5毫米范围内。平均手术时间为47分钟,无术中并发症。无白质脑病报告,3例患者有轻微的延迟并发症。
无框架手术导航是一种有用且有效的方法,可确保奥马亚贮液器植入期间导管放置准确,并降低潜在脑实质毒性风险。