Two-Micron Continuous-Wave Laser-Assisted Neuroendoscopy: Clinical Experience of Two Institutions in 524 Procedures
World Neurosurgery, cilt.122, 2019 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 122
- Basım Tarihi: 2019
- Doi Numarası: 10.1016/j.wneu.2018.09.064
- Dergi Adı: World Neurosurgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Anahtar Kelimeler: Cyst fenestration, Endoscopic third ventriculostomy, Laser, Neuroendoscopy, Septostomy
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Objective: To present the clinical experience of 2 neurosurgical centers with the use of a 2-micron continuous-wave laser (2μ-cwL) system as standard tool in neuroendoscopic procedures and to discuss the safety and efficacy of this system. Methods: In total, 469 patients underwent neuroendoscopic procedures using 2μ-cwL between September 2009 and January 2015. All patient data were retrospectively reviewed. In total, 241 (51%) patients were children and 228 (49%) adults. Mean age was 27.5 years (range: 3 days to 83 years). Intraoperative ultrasonography or neuronavigation were used to guide ventricular or cyst puncture and for intraventricular or intracystic orientation if necessary. Results: A total of 524 neuroendoscopic procedures using 2μ-cwL were performed. Laser-assisted endoscopic third ventriculostomy was the most common procedure in 302 (64%) patients. Cyst fenestration was performed in 124 (26%), septostomy in 45, tumor biopsy in 41, tumor resection in 8, and choroid plexus coagulation in 3 patients. There was no intraoperative complication directly attributable to the use of laser and an overall procedural complication rate of 4.8%. Conclusions: This large series of 2μ-cwL as a routine tool in neuroendoscopic procedures demonstrates that 2μ-cwL is safe for endoscopic third ventriculostomy, septostomy, cyst fenestration, and intraventricular tumor biopsy or resection. As a cutting and coagulation tool, it combines the action of mechanical tools like forceps, balloons, and scissors plus those of electric tools. It therefore renders neuroendoscopic procedures more straightforward with a minimum need to change tools.