预防腰腹膜分流术中的瓣膜反转：使用内联分流器放置于浅筋膜上方的有效性

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-08-18 DOI:10.1016/j.clineuro.2025.109113

Tatsuya Tanaka, Eiichi Suehiro, Akira Saito, Shuhei Yamasaki, Ryohei Sashida, Tomihiro Wakamiya, Kimihiro Nakahara, Takashi Agari, Masahiro Indou, Takashi Sugawara, Hiroshi Itokawa, Kazuaki Shimoji, Keisuke Onoda, Akira Matsuno

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引用次数: 0

摘要

腰腹腔分流术（LPS）手术后瓣膜反转可导致瓣膜调整错误或失效，潜在地引起并发症，如过度引流和慢性硬膜下血肿。虽然适当的固定和放置深度被认为对预防很重要，但有效的策略尚未得到很好的确立。方法回顾性分析2021年1月至2024年12月在我院进行的30例LPS手术。该技术包括使用内嵌分流器将瓣膜置于浅筋膜上方，并通过筋膜缝合形成筋膜鞘。术后使用CT或x线成像评估瓣膜位置并检测反转。结果30例患者中，男性17例，女性13例，平均年龄73.3岁，无瓣膜反转发生（0 %）。皮肤到瓣膜中心的平均距离为6.1 mm，棘突到瓣膜的平均距离为7.9 cm。结论将瓣膜置入浅筋膜上方，结合筋膜鞘形成，是预防LPS手术后瓣膜反转的有效策略。该技术可以提供可靠和可重复的方法来确保瓣膜的稳定性，无论解剖位置如何，都有可能提高术后安全性。

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Prevention of valve reversal in lumboperitoneal shunt surgery: Effectiveness of above-the-superficial-fascia placement using an inline shunt passer

Background

Valve reversal following lumboperitoneal shunt (LPS) surgery can lead to valve mis adjustment or failure, potentially causing complications such as overdrainage and chronic subdural hematoma. While proper fixation and placement depth are considered important for prevention, effective strategies have not been well established.

Methods

We retrospectively analyzed 30 LPS procedures performed at our institution from January 2021 to December 2024. The technique involved valve placement above the superficial fascia using an inline shunt passer, combined with fascial sheath formation via fascial suturing. Postoperative CT or X-ray imaging was used to assess valve position and detect reversal.

Results

Among the 30 patients (17 men and 13 women; mean age, 73.3 years), no cases of valve reversal were observed (0 %). The mean distance from the skin to the valve center was 6.1 mm, and the mean distance from the spinous process to the valve was 7.9 cm.

Conclusions

Placement of the valve above the superficial fascia using an inline shunt passer, combined with fascial sheath formation, appears to be an effective strategy for preventing valve reversal after LPS surgery. This technique may offer a reliable and reproducible method to ensure valve stability regardless of anatomical positioning, with potential to improve postoperative safety.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.