Tercer ventriculostomía endoscópica en niños hidrocefálicos menores de un año

Luis Alonso Fernández, Tania Leyva Mastrapa, Enrique de Jongh Cobo, Manuel Álvarez Nápoles

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Resumen

OBJETIVOS: 1) Determinar los resultados de la tercer ventriculostomía endoscópica en niños hidrocefalicos menores de 1 año de edad tratados en el Hospital Pediátrico “Juan Manuel Márquez”, 2) Definir los factores que pueden influir en el fallo de la tercer ventriculostomía endoscópica en este grupo de edad, 3) Relacionar la edad y la causa de los diferentes grupos etarios estudiados con la indicación de realizar una tercer ventriculostomía endoscópica.

MÉTODOS: Se trataron por este método 12 pacientes entre 6 días y 1 año de edad en el departamento de Neurocirugía del Hospital Pediátrico “Juan Manuel Márquez”, La Habana, Cuba. La técnica quirúrgica básica fue un abordaje en el ángulo externo de la fontanela o un trépano frontal en niños mayores permitiendo el acceso al sistema ventricular.

RESULTADOS: La tercer ventriculostomía endoscópica fue exitosa en el tratamiento de la hidrocefalia de cinco pacientes (42 %). La técnica neuroendoscópica no produjo complicaciones graves.

CONCLUSIONES: Las posibilidades de éxito de la tercer ventriculostomía endoscópica se incrementan con la edad. Este debe ser el tratamiento de elección en pacientes hidrocefálicos de más de 3 meses de edad. Son necesarios en el futuro ensayos prospectivos más largos, multicéntricos y con un mayor número de pacientes.

Palabras clave

Derivación ventrículo–peritoneal; Hidrocefalia; Lactantes; Tercer ventriculostomía endoscópica

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