Konovalov Anton Nikolaevich, Grebenev Fiodor Viacheslavovich, Rybakov Vladimir Alexandrovich, Pilipenko Yuri Victorovich, Shekhtman Oleg Dmitrievich, Okishev Dmitry Nicolaevich, Yershova Olga Nikolayevna, Eliava Shalva Shalvovich
Burdenko Neurosurgical Center, Moscow, Russia.
Burdenko Neurosurgical Center, Moscow, Russia.
World Neurosurg. 2021 Dec;156:e276-e282. doi: 10.1016/j.wneu.2021.09.051. Epub 2021 Sep 20.
The setting of external ventricular drainage (EVD) is one of the most frequent procedures in the neurosurgical practice. However, complication risks of this procedure may grow from 5% to 39%. The number of publications concerning the advancement of ventricular drainage setting technique and complication risks identification is increasing year after year. We posed a question on the dependence of complication risks and catheter setting accuracy on the different factors of routine practice of the N. N. Burdenko National Medical Research Center for neurosurgery within the scope of this work.
The data on patients whose EVD was set in the premotor area in 2019 were collected retrospectively. The surgeons were divided into 3 groups according to their experience valued in years.
The result of drainage setting was considered satisfactory if its end was in the frontal horn or body of the ipsilateral ventricle. Generally, 122 patients passed EVD placement during 2019. According to computed tomography scans of the brain, the drainage position was satisfactory in 85 patients (75.9%) and unsatisfactory in 27 patients (24.1%).
The procedures were performed by surgeons with <2 years of experience in 16.1% of cases, 2-5 years of experience in 25% of cases, and >5 years of experience in 58.9% of cases. The complication risk and accuracy of drainage setting do not depend on surgeon experience, type of bone access, and position in the premotor area.
脑室外引流（EVD）置管是神经外科手术中最常见的操作之一。然而，该操作的并发症风险可能从5%增至39%。关于脑室引流置管技术进展及并发症风险识别的出版物数量逐年增加。在本研究范围内，我们针对俄罗斯国立医学研究中心神经外科常规操作的不同因素对并发症风险和导管置管准确性的依赖性提出了一个问题。
回顾性收集2019年在运动前区进行EVD置管的患者数据。根据外科医生的年资将其分为3组。
如果引流管末端位于同侧脑室额角或脑室体部，则认为引流置管结果满意。2019年共有122例患者接受了EVD置管。根据脑部计算机断层扫描，85例患者（75.9%）的引流位置满意，27例患者（24.1%）的引流位置不满意。
16.1%的手术由经验不足2年的外科医生完成，25%的手术由经验为2至5年的外科医生完成，58.9%的手术由经验超过5年的外科医生完成。并发症风险和引流置管的准确性并不取决于外科医生的经验、骨窗类型以及在运动前区的位置。
