Neuroendoscopic procedures in achievement of shunt independence: outcome analysis of 28 patients with shunt malfunction.
OBJECTIVE
The authors review their experience of the TV-controlled endoscopic technique in the treatment of shunt malfunction in 28 patients suffering from hydrocephalus.


METHODS
We treated 28 patients (6.6+/-1.2 years) with shunt malfunctions by a neuroendoscopic procedure. The number of reimplantations of the shunt systems prior to the neuroendoscopic procedure varied from 1 to 13. Duration of the shunt dependency has averaged to 42.7+/-8.1 months (range: 5-180 months). All procedures were performed with the Gaab I neuroendoscope and Gaab II miniature neuroendoscope. All patients presented with neurological signs and deficits. The follow-up period has averaged to 32.3+/-6.2 months (4-114 months).


CONCLUSIONS
Endoscopic surgery offers an effective technique in the surgical treatment of shunt malfunction. On the basis of our experience, the use of a neuroendoscopic procedure for shunt malfunction allows us to achieve shunt independence in 82.1% and shunt removal in 50.0%. The introduction of these methods is recommended in neurosurgical centers that are traditionally widely engaged in the treatment of hydrocephalus.
Russian Academy of Medical Sciences, East-Siberian Minimally Invasive Neurosurgical Centre, Irkutsk, Russia. sufi anov@bk.ru
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Sufianov
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Sufianova
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Iakimov
D000293:Adolescent; D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000295:instrumentation; D044582:Neuroendoscopes; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000295:instrumentation*