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Revista Cubana de Cirugía

On-line version ISSN 1561-2945

Abstract

ALONSO FERNANDEZ, Luis; LEYVA MASTRAPA, Tania  and  DE JONGH COBO, Enrique. Pediatric neuroendoscopy: preliminary analysis of the first 32 cases. Rev Cubana Cir [online]. 2008, vol.47, n.1, pp. 0-0. ISSN 1561-2945.

INTRODUCTION. The endoscopic techniques have been used more frequently in the last years, which is associated with the development of new lens and cameras. In neurosurgery, they are used for the treatment of non-communicating hydrocephaly, biopsy of the intraventricular tumors and the fenestration of intracranial cysts, among other multiple indications. METHODS. This procedure was carried out in "Juan Manuel Márquez" Pediatric Teaching Hospital from August 2003 to August 2005. The patients were 32 children between 6 days and 15 years old. The basic surgical technique was applied through a hole made by frontal trephination that allowed the access to the ventricular system and the performance of the procedure depending on the diagnosis. The patients were followed up and evaluated by computerized axial tomography at 3, 6 and 12 postoperative months. RESULTS. The patients treated mainly suffered from hydrocephaly and intracranial tumors and cysts. The age group 10-15 (13 children, 40 %) predominated. 8 patients were under 1, accounting for 28 % of the total. The most common aetiology was the non-communicating hydrocephaly, which in 15 patients was secondary to an aqueductal stenosis. The most frequent endoscopic procedure was the premammillary ventriculostomy of the third ventricle. It was possible to carry out the communication procedure and the patients's symptoms decreased. The postoperative evolution was successful in 27 patients (84 %) and only 5 patients (16 %) did not resolve. The method did not produce severe complications. CONCLUSIONS. The neuroendoscopy proved to be an alternative to the derivations in certain patients, specially in children with non-communicating hydrocephaly. It allowed a significant reduction of the expenses in derivative systems and diminished the range of complications, with which the length of hospital stay was considerably shorter

Keywords : Neuroendoscopy; third ventricle ventriculostomy; non-communicating hydrocephayly; intracranial tumors; intracranial cysts.

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