Application of neuroendoscopic surgical techniques in the assessment and treatment of cerebral ventricular infection

作     者：Feng Guan Wei-Cheng Peng Hui Huang Zu-Yuan Ren Zhen-Yu Wang Ji-Di Fu Ying-Bin Li Feng-Qi Cui Bin Dai Guang-Tong Zhu Zhi-Yong Xiao Bei-Bei Mao Zhi-Qiang Hu 

作者机构：Department of Neurosurgery Beijing Shijitan Hospital Capital Medical University Beijing China Department of Neurosurgery Peking Union Medical College Hospital Beijing China Department of Neurosurgery Peking University Third Hospital Peking University Beijing China Department of Neurosurgery Beijing Tongren Hospital Capital Medical University Beijing China Department of Neurosurgery the Second Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu Province China Department of Neurosurgery Beijing Liangxiang Hospital Beijing China 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2019年第14卷第12期

页      面：2095-2103页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1002[医学-临床医学] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100215[医学-康复医学与理疗学] 10[医学] 

基　　金：supported by the Capital Health Research and Development of Special Funding Support of China,No.2011-2008-06(to ZQH) Capital Characteristic Clinical Application Research of China,No.Z131107002213044(to ZQH) Beijing Municipal Administration of Hospitals Incubating Program of China,No.PX2019026(to FG) 

主　　题：nerve regeneration neuroendoscopy surgery cerebral ventricular infection assessment treatment hydrocephalus irrigation neural regeneration 

摘      要：Cerebral ventricular infection (CVI) is one of the most dangerous complications in neurosurgery because of its high mortality and disability rates. Few studies have examined the application of neuroendoscopic surgical techniques (NESTs) to assess and treat CVI. This multicenter, retrospective study was conducted using clinical data of 32 patients with CVI who were assessed and treated by NESTs in China. The patients included 20 men and 12 women with a mean age of 42.97 years. NESTs were used to obliterate intraventricular debris and pus, fenestrate or incise the intraventricular compartment and reconstruct cerebrospinal fluid circulation, and remove artificial material. Intraventricular irrigation with antibiotic saline was applied after neuroendoscopic surgery (NES). Secondary hydrocephalus was treated by endoscopic third ventriculostomy or a ventriculoperitoneal shunt. Neuroendoscopic findings of CVI were used to classify patients into Grade Ⅰ(n = 3), Grade Ⅱ(n = 13), Grade Ⅲ(n = 10), and Grade Ⅳ(n = 6) CVI. The three patients with grade ⅠCVI underwent one NES, the 23 patients with grade Ⅱ/Ⅲ CVI underwent two NESs, and patients with grade Ⅳ CVI underwent two (n = 3) or three (n = 3) NESs. The imaging features and grades of neuroendoscopy results were positively related to the number of neurosurgical endoscopic procedures. Two patients died of multiple organ failure and the other 30 patients fully recovered. Among the 26 patients with secondary hydrocephalus, 18 received ventriculoperitoneal shunt and 8 underwent endoscopic third ventriculostomy. There were no recurrences of CVI during the 6- to 76-month follow-up after NES. Application of NESTs is an innovative method to assess and treat CVI, and its neuroendoscopic classification provides an objective, comprehensive assessment of CVI. The study trial was approved by the Institutional Review Board of Beijing Shijitan Hospital, Capital Medical University, China.