Safdar Shehzad, Mansoor Usama, Omer Asad O, Waraich Tauqir Aslam, Ali Ajlan, Saleem Rabia
Neurosurgery, Beaumont Hospital, Dublin, IRL.
Neurosurgery, Punjab Institute of Neurosciences, Lahore, PAK.
Cureus. 2025 Mar 29;17(3):e81423. doi: 10.7759/cureus.81423. eCollection 2025 Mar.
Background The ventriculoperitoneal (VP) shunt is crucial for draining excess cerebrospinal fluid, preventing complications like elevated intracranial pressure. Common points for the procedure, such as Keen's and Frazier's points, are established, with emerging interest in Choudhary's point. Despite advancements, the challenge remains, as studies reveal cases with incorrectly placed catheter tips, emphasizing the ongoing need for improved ventriculostomy techniques. Objective To assess and compare the efficacy of VP shunting utilizing Keen's point versus Frazier's point in individuals diagnosed with hydrocephalus. Methodology From February to August 2022, this non-randomized controlled trial was conducted at Unit II, Department of Neurosurgery, Lahore General Hospital, Lahore. The study included 438 patients divided into two groups (Group A with Frazier's point and Group B with Keen's point), with 219 patients in each group, allocated based on the attending surgeon's preference. Effectiveness was evaluated post-procedure in the post-surgical ward using CT scans, focusing on factors such as optimal ventricular catheter tip position and minimal brain parenchymal damage. Data analysis utilized IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Results In the Frazier's point group, the mean age was 18.47±9.21 years, while in the Keen's point group, it was 19.06±10.43 years. The duration of symptoms was 2.59±1.189 months in Frazier's point group and 2.65±1.237 months in Keen's point group. Gender distribution showed 42.5% males and 57.5% females in Frazier's point group and 40.6% males and 59.4% females in Keen's point group. The effectiveness of the VP shunting procedure was observed in 175 (79.9%) cases in Frazier's point group and 133 (60.7%) in Keen's point group (p <0.0001). Conclusion The study concludes that VP shunting at Frazier's point demonstrates superior effectiveness compared to Keen's point, supporting its consideration for hydrocephalus management across pediatric and adult populations.
脑室腹腔（VP）分流术对于引流过多脑脊液、预防颅内压升高等并发症至关重要。该手术的常见穿刺点，如基恩点和弗雷泽点已确立，乔杜里点也逐渐受到关注。尽管取得了进展，但挑战依然存在，因为研究显示存在导管尖端放置错误的病例，这凸显了持续改进脑室造瘘技术的必要性。
评估和比较在诊断为脑积水的个体中，利用基恩点与弗雷泽点进行VP分流术的疗效。
2022年2月至8月，在拉合尔总医院神经外科二病区进行了这项非随机对照试验。该研究纳入438例患者，分为两组（A组采用弗雷泽点，B组采用基恩点），每组219例患者，根据主刀医生的偏好进行分配。术后在外科病房使用CT扫描评估疗效，重点关注脑室导管尖端最佳位置和脑实质最小损伤等因素。数据分析使用IBM公司2012年发布的IBM SPSS Statistics for Windows，版本21.0。纽约州阿蒙克：IBM公司。
在弗雷泽点组，平均年龄为18.47±9.21岁，而在基恩点组为19.06±10.43岁。弗雷泽点组症状持续时间为2.59±1.189个月，基恩点组为2.65±1.237个月。性别分布显示，弗雷泽点组男性占42.5%，女性占57.5%；基恩点组男性占40.6%，女性占59.4%。在弗雷泽点组，175例（79.9%）病例观察到VP分流术有效，基恩点组为133例（60.7%）（p<0.0001）。
该研究得出结论，与基恩点相比，在弗雷泽点进行VP分流术显示出更高的有效性，支持在儿科和成人人群的脑积水治疗中考虑采用该方法。
