Carvalho Fernanda O de, Bellas Antonio R, Guimarães Luciano, Salomão José Francisco
Serviço de Neurocirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Departamento de Cirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Arq Neuropsiquiatr. 2014 Apr;72(4):307-11. doi: 10.1590/0004-282x20140007.
Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus.
To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a "non reliable" peritoneum.
From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy.
After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far.
Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.
多次分流失败是小儿神经外科实践中的一项挑战，也是脑积水最令人恐惧的并发症之一。
证明对于因反复腹腔操作、腹部假性囊肿、腹膜炎或其他导致“不可靠”腹膜的情况而接受多次翻修的患者，腹腔镜下处理远端脑室腹腔分流失败可能是一种有效的选择。
2012年3月至2013年2月，作者回顾性分析了在本院出生并随访的6例患者的病历，这些患者既往有腹腔内并发症，并在电视腹腔镜辅助下接受了脑室腹腔分流翻修术。
平均随访9个月后，所有患者情况良好，目前未发现进一步的分流失败。
在某些情况下，腹腔镜辅助下的小儿分流翻修术对于因脑室腹腔分流导致多次腹膜并发症的患者可能是一种有效的选择。
