Should a VP or LP Shunt be Used for the Treatment of Pseudotumorcerebri in Adults?

Hassan Kadri, Raed Abouharb, Rostom Mackieh, Rafik Haider, Tim Kadri
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Abstract

Introduction: Pseudotumorcerebri(PTC) is a condition characterized by false brain tumor symptoms, caused by high intracranial pressure (ICP). Treatment options include medication, weight loss, surgery, and shunting. Shunting, either ventriculoperitoneal (VP) or lumboperitoneal (LP), emerged as the preferred method of treatment, but there is an ongoing debate as to which technique should be prioritized. The aim of this study is to gather additional evidence to determine the optimal type of shunt for treating PTC. Materials and Methods: Ninety patients with PTC were studied at Damascus University between 2016 and 2021. The study monitored symptoms before and after treatment, with improvement related to the technique used (VP or LP shunts). Of all patients, 83 were women and 7 were men. In addition, complications were analyzed. Results: Both shunts showed similar postoperative rates of symptom improvement, but VP shunts were utilized more frequently overall in this study. Patients who received LP shunt surgery had a higher rate of postoperative complications compared to those who received VP shunt surgery, but the chi-squared analysis did not provide sufficient evidence to confirm a significant relationship between the type of surgery and the occurrence of postoperative complications. Conclusion: Despite ongoing controversy about the optimal treatment for benign intracranial hypertension (BTC), most authors approved the trend of using VP (ventriculoperitoneal) shunts, given a lower rate of complications. However, there is no statistically significant difference between outcomes of VP and LP (lumboperitoneal) shunting techniques, according to our research.
成人假性脑肿瘤应该使用VP或LP分流术吗?
前言:假性脑瘤(PTC)是一种由高颅内压(ICP)引起的以假性脑瘤症状为特征的疾病。治疗方案包括药物治疗、减肥、手术和分流术。脑室-腹膜(VP)或腰腹膜(LP)分流术是首选的治疗方法,但关于哪种技术应该优先使用仍存在争议。本研究的目的是收集更多的证据来确定治疗PTC的最佳分流器类型。材料与方法:2016年至2021年在大马士革大学研究了90例PTC患者。该研究监测了治疗前后的症状,与所使用的技术(VP或LP分流)相关的改善。在所有患者中,83名女性和7名男性。并对并发症进行了分析。结果:两种分流术显示出相似的术后症状改善率,但在本研究中,VP分流术的总体使用频率更高。LP分流术患者术后并发症发生率高于VP分流术患者,但卡方分析并没有提供足够的证据来证实手术类型与术后并发症发生之间的显著关系。结论:尽管关于良性颅内高压(BTC)的最佳治疗方法仍存在争议,但鉴于并发症发生率较低,大多数作者赞成使用VP(脑室-腹膜)分流的趋势。然而,根据我们的研究,VP和LP(腰腹膜)分流技术的结果没有统计学上的显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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