Tratamiento de la hidrocefalia mediante la derivación ventriculopleural
Ventriculopleural shunt to treat hydrocephalus
J. Torres Lanzasa, A. Ríos Zambudiob,
, J.F. Martínez Lagec, M.J. Roca Calvoa, M. Pozac, P. Parrilla Pariciob
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a Servicio de Cirugía Torácica. Hospital Universitario Virgen de la Arrixaca. Murcia. España
b Servicio de Cirugía General y del Aparato Digestivo I. Hospital Universitario Virgen de la Arrixaca. Murcia. España
c Unidad de Neurocirugía Pediátrica. Hospital Universitario Virgen de la Arrixaca. Murcia. España
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"apellidos" => "Parrilla Paricio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica. Hospital Universitario Virgen de la Arrixaca. Murcia. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía General y del Aparato Digestivo I. Hospital Universitario Virgen de la Arrixaca. Murcia. España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Neurocirugía Pediátrica. Hospital Universitario Virgen de la Arrixaca. Murcia. España" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Avda. de la Libertad, 208. 30007 Casillas. Murcia. España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ventriculopleural shunt to treat hydrocephalus" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-01-18" "fechaAceptado" => "2002-03-13" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190651" "palabras" => array:6 [ 0 => "Hidrocefalia" 1 => "Derivación ventriculopleural" 2 => "Adherencias peritoneales" 3 => "Válvulas programables" 4 => "Infección valvular" 5 => "Líquido cefalorraquídeo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190652" "palabras" => array:6 [ 0 => "Hydrocephalus" 1 => "Ventriculopleural shunt" 2 => "Peritoneal adhesion" 3 => "Programable valves" 4 => "Valve infection" 5 => "Cerebrospinal fluid" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La derivación ventriculoatrial y la ventriculopleural (DVP) son métodos alternativos a la derivación ventriculoperitoneal para el drenaje del líquido cefalorraquídeo (LCR) en pacientes con hidrocefalia. La DVP ha sido poco utilizada por su riesgo de insuficiencia respiratoria por neumotórax o derrame pleural; sin embargo, la presencia actual de válvulas con dispositivos antisifón para los sistemas de derivación estándar previene el desarrollo de estos derrames pleurales. El objetivo es analizar los resultados de nueve DVP en 8 pacientes con las nuevas válvulas de DVP para evitar el drenaje excesivo de LCR.</p> <span class="elsevierStyleSectionTitle">Material y Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Entre 1988 y 2000 se han realizado nueve DVP en 8 pacientes con hidrocefalia. Ocho válvulas eran de presión diferencial y una, reguladora de flujo. Además, seis (el modelo Sophy) son programables externamente. La indicación de la DVP fue, en 4 casos, la presencia de adherencias peritoneales; en dos, la presencia de ascitis persistente, en uno la obstrucción de la válvula ventriculoatrial, y en el último, la infección de la derivación peritoneal por una peritonitis. El noveno caso corresponde al recambio de una válvula previa obstruida.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Tras un seguimiento medio de 22 meses, todas las derivaciones funcionan de forma adecuada y ningún paciente presenta síntomas de hidrocefalia, excepto un caso que precisó recambio valvular por obstrucción de la misma a los 6 meses. No se presentó morbimortalidad asociada a la técnica quirúrgica. Sólo un paciente mostró síntomas transitorios de drenaje excesivo de LCR, lo que fue corregido regulando el gradiente de la válvula magnética. Un paciente falleció a los 36 meses por un procedimiento no relacionado con el drenaje pleural.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El uso de válvulas de nuevo diseño designadas para prevenir el sobredrenaje de LCR presenta unos resultados satisfactorios, por lo que la DVP debe considerarse como una alternativa al drenaje peritoneal.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Ventriculoatrial and ventriculopleural shunts (VPS) are alternatives to ventriculoperitoneal shunts for draining cerebrospinal fluid from patients with hydrocephalus. VPS has seldom been used because of the risk of respiratory insufficiency due to pneumothorax or pleural effusion. However, valves are currently available with antisiphon devices for use with standard shunting systems to prevent the development of pleural effusion. The aim of this study was to analyze outcome after VPS in eight patients in whom we used the new valves for avoiding overdrainage of cerebrospinal fluid.</p> <span class="elsevierStyleSectionTitle">Material and Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Nine VPS procedures were performed in eight hydrocephalic patients between 1988 and 2000. We used differential pressure valves in eight procedures and a flow regulator valve in one. The externally adjustable Sophy valve was used in six cases. The indication for VPS was peritoneal adhesions in four cases, persistent ascites in two, ventriculoatrial valve obstruction in one, and infection of the peritoneal shunt (peritonitis) in one. The ninth case involved replacement of a previously obstructed valve.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">After a follow-up period of 22 months all shunts were functioning well and the only patient with symptoms of hydrocephalus was the one who required valve replacement at six months. No surgical morbidity or mortality was observed, and only one patient developed transitory signs of excessive cerebrospinal fluid drainage, which was corrected by regulating the magnetic valve gradient. The death of one patient 36 months after surgery was unrelated to pleural drainage.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Valves newly designed to prevent overdrainage of cerebrospinal fluid give satisfactory results, such that VPS should be considered as an alternative to peritoneal drainage.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hydrocephalus-clinical features and management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.N. Detwiler" 1 => "R.W. Porter" 2 => "H.L. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 15 | 7 | 22 |
| 2024 October | 147 | 42 | 189 |
| 2024 September | 170 | 45 | 215 |
| 2024 August | 121 | 67 | 188 |
| 2024 July | 116 | 49 | 165 |
| 2024 June | 124 | 38 | 162 |
| 2024 May | 107 | 40 | 147 |
| 2024 April | 63 | 50 | 113 |
| 2024 March | 68 | 102 | 170 |
| 2024 February | 64 | 60 | 124 |
| 2024 January | 0 | 16 | 16 |
| 2023 December | 0 | 14 | 14 |
| 2023 November | 0 | 44 | 44 |
| 2023 October | 0 | 18 | 18 |
| 2023 September | 0 | 2 | 2 |
| 2023 July | 0 | 5 | 5 |
| 2023 June | 0 | 23 | 23 |
| 2023 May | 0 | 2 | 2 |
| 2023 April | 0 | 4 | 4 |
| 2023 March | 6 | 10 | 16 |
| 2023 February | 35 | 54 | 89 |
| 2023 January | 29 | 38 | 67 |
| 2022 December | 30 | 37 | 67 |
| 2022 November | 42 | 12 | 54 |
| 2022 October | 30 | 39 | 69 |
| 2022 September | 29 | 29 | 58 |
| 2022 August | 42 | 45 | 87 |
| 2022 July | 24 | 37 | 61 |
| 2022 June | 25 | 43 | 68 |
| 2022 May | 35 | 38 | 73 |
| 2022 April | 47 | 24 | 71 |
| 2022 March | 35 | 37 | 72 |
| 2022 February | 29 | 24 | 53 |
| 2022 January | 28 | 36 | 64 |
| 2021 December | 26 | 46 | 72 |
| 2021 November | 27 | 57 | 84 |
| 2021 October | 30 | 72 | 102 |
| 2021 September | 21 | 55 | 76 |
| 2021 August | 21 | 50 | 71 |
| 2021 July | 20 | 32 | 52 |
| 2021 June | 27 | 58 | 85 |
| 2021 May | 19 | 45 | 64 |
| 2021 April | 47 | 62 | 109 |
| 2021 March | 47 | 57 | 104 |
| 2021 February | 23 | 20 | 43 |
| 2021 January | 23 | 30 | 53 |
| 2020 December | 29 | 28 | 57 |
| 2020 November | 23 | 23 | 46 |
| 2020 October | 35 | 34 | 69 |
| 2020 September | 28 | 108 | 136 |
| 2020 August | 39 | 113 | 152 |
| 2020 July | 22 | 97 | 119 |
| 2020 June | 14 | 59 | 73 |
| 2020 May | 23 | 38 | 61 |
| 2020 April | 29 | 93 | 122 |
| 2020 March | 23 | 20 | 43 |
| 2020 February | 22 | 34 | 56 |
| 2020 January | 73 | 52 | 125 |
| 2019 December | 41 | 44 | 85 |
| 2019 November | 21 | 58 | 79 |
| 2019 October | 19 | 79 | 98 |
| 2019 September | 32 | 117 | 149 |
| 2019 August | 22 | 60 | 82 |
| 2019 July | 49 | 87 | 136 |
| 2019 June | 37 | 86 | 123 |
| 2019 May | 42 | 95 | 137 |
| 2019 April | 31 | 87 | 118 |
| 2019 March | 29 | 34 | 63 |
| 2019 February | 21 | 32 | 53 |
| 2019 January | 29 | 32 | 61 |
| 2018 December | 32 | 40 | 72 |
| 2018 November | 36 | 34 | 70 |
| 2018 October | 68 | 37 | 105 |
| 2018 September | 48 | 23 | 71 |
| 2018 June | 3 | 0 | 3 |
| 2018 May | 15 | 3 | 18 |
| 2018 April | 47 | 11 | 58 |
| 2018 March | 17 | 10 | 27 |
| 2018 February | 9 | 13 | 22 |
| 2018 January | 9 | 17 | 26 |
| 2017 December | 14 | 25 | 39 |
| 2017 November | 19 | 57 | 76 |
| 2017 October | 17 | 94 | 111 |
| 2017 September | 26 | 83 | 109 |
| 2017 August | 21 | 66 | 87 |
| 2017 July | 18 | 62 | 80 |
| 2017 June | 15 | 78 | 93 |
| 2017 May | 16 | 83 | 99 |
| 2017 April | 13 | 58 | 71 |
| 2017 March | 9 | 77 | 86 |
| 2017 February | 35 | 63 | 98 |
| 2017 January | 24 | 25 | 49 |
| 2016 December | 40 | 40 | 80 |
| 2016 November | 50 | 43 | 93 |
| 2016 October | 63 | 42 | 105 |
| 2016 September | 48 | 38 | 86 |
| 2016 August | 33 | 16 | 49 |
| 2016 July | 33 | 11 | 44 |
| 2016 June | 44 | 19 | 63 |
| 2016 May | 38 | 17 | 55 |
| 2016 April | 21 | 1 | 22 |
| 2016 March | 20 | 3 | 23 |
| 2016 February | 16 | 2 | 18 |
| 2016 January | 23 | 16 | 39 |
| 2015 December | 42 | 21 | 63 |
| 2015 November | 47 | 12 | 59 |
| 2015 October | 519 | 2 | 521 |
| 2015 September | 584 | 0 | 584 |
| 2015 August | 519 | 0 | 519 |
| 2015 July | 620 | 0 | 620 |
| 2015 June | 513 | 0 | 513 |
| 2015 May | 709 | 0 | 709 |
| 2015 April | 625 | 0 | 625 |
| 2015 March | 701 | 0 | 701 |
| 2015 February | 446 | 0 | 446 |
| 2015 January | 472 | 0 | 472 |
| 2014 December | 386 | 0 | 386 |
| 2014 November | 518 | 0 | 518 |
| 2014 October | 667 | 0 | 667 |
| 2014 September | 563 | 0 | 563 |
| 2014 August | 490 | 0 | 490 |
| 2014 July | 504 | 0 | 504 |
| 2014 June | 499 | 0 | 499 |
| 2014 May | 657 | 0 | 657 |
| 2014 April | 545 | 0 | 545 |
| 2014 March | 479 | 0 | 479 |
| 2014 February | 408 | 0 | 408 |
| 2014 January | 304 | 0 | 304 |
| 2013 December | 233 | 0 | 233 |
| 2013 November | 308 | 0 | 308 |
| 2013 October | 334 | 0 | 334 |
| 2013 September | 245 | 0 | 245 |
| 2013 August | 264 | 0 | 264 |
| 2013 July | 286 | 0 | 286 |
| 2013 June | 206 | 0 | 206 |
| 2013 May | 158 | 0 | 158 |
| 2013 April | 93 | 0 | 93 |
| 2013 March | 23 | 0 | 23 |
| 2000 January | 7593 | 0 | 7593 |
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