Artikel
2 micron Laser assisted neuroendoscopic procedures: Clinical experience of two different institutions with 469 patients
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Autoren
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Hans-Christoph Ludwig
- Schwerpunkt Kinderneurochirurgie, Neurochirurgische Klinik, Universitätsmedizin Göttingen UMG, Göttingen, Deutschland
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Cahit Kural
- Bereich Pädiatrische Neurochirurgie, Klinik für Neurochirurgie, Universtätsklinikum Tübingen, Tübingen, Deutschland
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Martin U. Schuhmann
- Bereich Pädiatrische Neurochirurgie, Klinik für Neurochirurgie, Universtätsklinikum Tübingen, Tübingen, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: The aim of this study is to present the clinical experience of 2 university hospitals on the use of 2-micron continuous wave laser in neuroendoscopic procedures and to discuss the safety and efficiency of this system in selected and appropriate lesions of central nervous system.
Methods: Four hundred and sixty nine cases underwent neuroendoscopic procedures using 2-micron continuous wave laser between September 2009 and January 2015. The data of the patients were retrospectively reviewed. Of the 469 cases, 241 (51%) were children and 228 (49%) were adults. The mean age was 27,5 years (ranged between 3 days and 83 years old) and 263 (56%) patients were male and 206 were female. Intraoperative ultrasound was used in 230 cases and neuronavigation was used in 239 patients for intraoperative orientation.
Results: A total of 524 neuroendoscopic procedures was performed in 469 patients. Laser-assisted endoscopic third ventriculostomy was the most common surgical procedure and it was performed in 302 (64%) cases. Cyst fenestration was performed in 124 (26%) cases, septostomy in 45, tumor biopsy in 41, tumor resection in 8 and choroid plexus coagulation in 3 cases. Postoperative complications were oculomotor palsy, subcutaneous cerebrospinal fluid collection, CSF fistula, subdural hygroma, rhinorrhea, hypoglicemia and diabetes incipidus. None of these complications was directly related to laser surgery.
Conclusion: The 2-micron continuous wave laser neuroendoscopy is a safe and effective procedure for endoscpic third ventriculostomy, septostomy, cyst fenestration and intraventricular tumor resection. Larger studies are needed to obtain better clinical outcomes.
