胶原基质硬脑膜替代移植物可预防1岁以下患者脑室腹腔分流术后的脑脊液漏。
The collagen matrix dural substitute graft prevents postoperative cerebrospinal fluid leakage after ventriculoperitoneal shunt surgery in patients aged <1 year.
作者信息
Sato Masanori, Oyoshi Tatsuki, Iwamoto Hirofumi, Tanoue Natsuko, Komasaku Soichiro, Higa Nayuta, Hosoyama Hiroshi, Tokimura Hiroshi, Ibara Satoshi, Hanaya Ryosuke, Yoshimoto Koji
机构信息
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University.
Department of Neurosurgery, Kagoshima City Hospital, Kagoshima, Japan.
出版信息
Surg Neurol Int. 2022 Oct 7;13:461. doi: 10.25259/SNI_629_2022. eCollection 2022.
BACKGROUND
Cerebrospinal fluid (CSF) leakage is a common complication of ventriculoperitoneal shunt (VPS) and has the potential to induce shunt infection. Especially in infants and children, these are serious complications. DuraGen is a collagen matrix dural substitute used to reduce the risk of CSF leakage in various neurosurgeries. We report our VPS procedure with DuraGen for preventing postoperative CSF leakage in patients aged <1 year.
METHODS
We used DuraGen to prevent postoperative CSF leakage in six VPS surgeries. Antibiotic-impregnated shunt catheters and programmable valves with anti-siphon devices were also used in all cases. DuraGen was placed inside and atop the burr hole. All cases had an initial shunt pressure of 5 cmH2O. Fibrin glue was not used.
RESULTS
The patients underwent follow-up for a year after VPS surgery. There was no postoperative subcutaneous CSF collection or leakage after all six VPS surgeries. Furthermore, no postoperative shunt infections or DuraGen-induced adverse events were noted.
CONCLUSION
We speculate that DuraGen has a preventive effect on postoperative CSF leakage in VPS cases aged <1 year.
背景
脑脊液漏是脑室腹腔分流术（VPS）的常见并发症，有可能引发分流感染。尤其是在婴幼儿中，这些都是严重的并发症。DuraGen是一种胶原基质硬脑膜替代物，用于降低各种神经外科手术中脑脊液漏的风险。我们报告了我们使用DuraGen进行VPS手术以预防1岁以下患者术后脑脊液漏的情况。
方法
我们在6例VPS手术中使用DuraGen预防术后脑脊液漏。所有病例均使用了含抗生素的分流导管和带有防虹吸装置的可编程阀门。DuraGen放置在钻孔内和钻孔上方。所有病例的初始分流压力均为5 cmH2O。未使用纤维蛋白胶。
结果
患者在VPS手术后接受了一年的随访。6例VPS手术后均未出现术后皮下脑脊液积聚或漏液。此外，未观察到术后分流感染或DuraGen引起的不良事件。
结论
我们推测DuraGen对1岁以下VPS病例的术后脑脊液漏有预防作用。
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