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脑积水患者在腹腔镜引导下进行脑室-腹腔分流术翻修术。

Revision of ventriculo-peritoneal shunt under laparoscopic guidance in patients with hydrocephalus.

作者信息

Kusano T, Miyazato H, Shimoji H, Hirayasu S, Isa T, Shiraishi M, Muto Y, Furukawa M

机构信息

First Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.

出版信息

Surg Laparosc Endosc. 1998 Dec;8(6):474-6.

PMID:9864118
Abstract

Ventriculo-peritoneal (V-P) shunt is a common treatment for hydrocephalus. However, shunt insufficiency due to obstruction, dislocation, and detachment of the peritoneal tube is frequently encountered. We designed a new technique in which the peritoneal tube is inserted into a target site of the abdominal cavity under laparoscopic guidance. We operated on 9 patients with hydrocephalus using this technique. Shunt insufficiency of the peritoneal tube had been observed in all patients, and 7 patients had undergone repeated revision of the peritoneal tube before this procedure. Our laparoscopic-assisted method ensured tube insertion into the appropriate site, and minimized the abdominal wound and postoperative adhesions. This method also made it possible to differentiate abdominal pain induced by shunt failure from pain caused by other diseases, including appendicitis. In conclusion, we consider this new technique for V-P shunt performed under laparoscopic guidance to be very useful.

摘要

脑室-腹腔(V-P)分流术是治疗脑积水的常用方法。然而,因腹腔导管阻塞、移位和脱离导致的分流不足情况屡见不鲜。我们设计了一种新技术,即在腹腔镜引导下将腹腔导管插入腹腔的目标部位。我们使用该技术为9例脑积水患者进行了手术。所有患者均出现过腹腔导管分流不足的情况,其中7例患者在此手术前曾多次对腹腔导管进行翻修。我们的腹腔镜辅助方法确保了导管插入合适的部位,最大限度地减少了腹部伤口和术后粘连。该方法还能够区分分流失败引起的腹痛与包括阑尾炎在内的其他疾病所致的疼痛。总之,我们认为这种在腹腔镜引导下进行V-P分流的新技术非常有用。

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