Ventriculo-pleural shunt --- A second line option in the management of complex hydrocephalus

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland Pub Date : 2025-02-25 DOI:10.1016/j.surge.2025.02.006

Hanqiao Li , John Caird

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引用次数: 0

Abstract

Background

Ventriculo-pleural (V-Pl) shunt is considered as an alternative management of hydrocephalus when previous management options of hydrocephalus, including ventriculoperitoneal (VP) shunt, ventriculo-atrial (VA) shunt and endoscopic third ventriculostomy (ETV), may be contraindicated or have failed.

Aim

The aim is to identify the indications of V-Pl shunt after the failure of first-line managements of hydrocephalus, to evaluate the efficacy of V-Pl shunt with regarding to other shunt options and to discuss the potential complications.

Methods

15 patients who underwent V-Pl shunt (or V-Pl shunt related surgeries) from 2021 to 2024, are recorded retrospectively. The data was collected via patients’ medical charts and national image archiving system (Republic of Ireland). Related literature and case reports were searched via keyword selections on research databases, including Pubmed and Google Scholar.

Results

The indications for shunt treatment were spina bifida, tumour related hydrocephalus, congenital hydrocephalus, arachnoid cysts and idiopathic intracranial hypertension. Indications for favouring V-Pl shunt over VP/VA shunt or ETV are multiple shunt failures, persistent shunt-related symptoms, severe kyphoscoliosis, abdominal ascites/pseudocyst, jugular vein thrombosis. Complications of V-Pl shunt include shunt failure, over-drainage, pleuritic chest pain, pneumothorax and rarely slit-ventricle syndrome.

Conclusion

V-Pl shunt can be considered as a second line management for hydrocephalus when VP/VA shunt and ETV options have been exhausted.

查看原文本刊更多论文

脑室-胸膜分流术——复杂脑积水治疗的二线选择。

背景：脑室-胸膜（V-Pl）分流术被认为是脑积水的另一种治疗方法，当脑室-腹膜（VP）分流术、脑室-心房（VA）分流术和内镜下第三脑室造口术（ETV）可能是禁忌或失败时。目的：目的是确定脑积水一线治疗失败后V-Pl分流术的适应症，评估V-Pl分流术与其他分流术的疗效，并讨论潜在的并发症。方法：回顾性分析2021年至2024年接受V-Pl分流术（或V-Pl分流术相关手术）的15例患者。数据通过患者病历和国家图像存档系统（爱尔兰共和国）收集。通过检索Pubmed和谷歌Scholar等研究数据库的关键词检索相关文献和病例报告。结果：分流治疗指征为脊柱裂、肿瘤相关性脑积水、先天性脑积水、蛛网膜囊肿、特发性颅内高压。V-Pl分流优于VP/VA分流或ETV分流的适应症是多次分流失败、持续分流相关症状、严重后凸性脊柱侧凸、腹水/假性囊肿、颈静脉血栓形成。V-Pl分流术的并发症包括分流失败、过度引流、胸膜性胸痛、气胸和罕见的狭缝脑室综合征。结论：当VP/VA分流术和ETV分流术已经用尽时，V-Pl分流术可以作为脑积水的二线治疗方法。

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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来源期刊

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 医学-外科

CiteScore

4.40

自引率

0.00%

发文量

158

审稿时长

6-12 weeks

期刊介绍： Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field. Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.