Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353, Berlin, Germany.
Division of Pediatric Neurosurgery, Kepler Universitätsklinikum, Linz, Austria.
Childs Nerv Syst. 2021 Nov;37(11):3549-3554. doi: 10.1007/s00381-021-05258-w. Epub 2021 Jun 29.
The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration.
On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported.
According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers.
Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.
TROPHY 注册中心已经成立，旨在对新生儿脑室内出血（IVH）相关脑积水的手术管理进行国际多中心前瞻性数据收集，以可能为未来的指南做出贡献。该注册中心允许比较治疗脑积水的技术，如外部脑室引流（EVD）、脑室接入装置（VAD）、脑室下颅骨分流（VSGS）和神经内镜灌洗（NEL）。该注册中心的第一份现状报告介绍了参与中心在在线注册时评估的标准治疗调查结果。
在标准治疗表格上，每个中心都表示在开始积极参与注册前 2 年内（Y1 和 Y2），为新生儿出血后脑积水（nPHH）实施的机构干预方案。此外，还报告了迄今为止登记的患者数量以及分配给治疗方法的数量。
根据 56 个已注册中心填写的标准治疗表格，使用 EVD 的中心数量减少（Y1 为 55%，Y2 为 46%），而更多的中心采用 NEL（Y1 为 39%；Y2 为 52%）来治疗 nPHH。VAD（Y1 为 66%；Y2 为 66%）和 VSGS（Y1 为 42%；Y2 为 41%）在这 2 年中的使用率保持一致。大多数中心使用至少两种不同的技术来治疗 nPHH（43%），而 27%的中心只使用一种技术，21%的中心使用三种技术，7%的中心甚至使用四种不同的技术。29 个中心提供了 110 名接受手术治疗的婴儿的数据（13%的 EVD，15%的 VAD，30%的 VSGS 和 43%的 NEL），这些婴儿的治疗时间为 2018 年 9 月至 2021 年 2 月。
我们的结果强调了治疗 nPHH 时使用的不同策略。国际 TROPHY 注册中心已经进入患者招募不断增加的阶段。将根据注册中心的协议进行进一步的评估和发布。
