Efficacy of simultaneous single-trajectory endoscopic @entity5 biopsy and endoscopic cerebrospinal fluid diversion procedures in intra- and XXXX .

@entity1 @entity1276 @entity548 @entity5 @entity8468
OBJECT: Intraventricular and @entity5 resulting in @entity1276 commonly require a CSF diversion procedure. A @entity5 biopsy can often be performed concurrently. Although the tissue samples obtained during endoscopic biopsy procedures are small, a diagnosis can be made in most cases. In the present study the authors analyzed the efficacy of concurrent endoscopic biopsy and CSF diversion procedures using a single bur hole and trajectory. METHODS: Eighty-seven @entity1 with intraventricular and @entity5 were treated with endoscopic biopsy and CSF diversion procedures using a rigid rod-lens endoscope or a rigid fiberscope during a 10-year period. All @entity1 underwent a @entity5 biopsy and an endoscopic third ventriculostomy (ETV), @entity8468 ( @entity8468 ), or ventriculoperitoneal (VP) shunting, depending on the @entity5 location and site of obstruction. A single bur hole for both procedures was used in all @entity1 . RESULTS: Among the 87 @entity1 , the biopsy was diagnostic in 72 (83%) and merely suggestive in 7 (8%); in 8 @entity1 (9%) the sample was nondiagnostic. Among the 22 @entity1 who underwent an initial endoscopic biopsy and subsequent procedures, the specimen obtained at the second surgery was concordant with the initial endoscopic biopsy sample in 13 @entity1 ; it was somewhat similar in 4 @entity1 . In the other 5 @entity1 , either a microsurgical or stereotactic approach was used to correctly diagnose the pathology. Fifty-five @entity1 were considered for endoscopic CSF diversion procedures; an ETV was performed in 52 @entity1 and @entity8468 in 2. An ETV could not be performed in 3 @entity1 for technical reasons. A VP shunt was inserted in 32 @entity1 , with 25 undergoing shunt placement at the same time as the ETV and 7 at a later date. Significant @entity548 was encountered in 3 @entity1 during the @entity5 biopsy and in 1 @entity1 during the ETV. The ETV failed in 1 @entity1 during the follow-up, and a repeat ETV was required. CONCLUSIONS: Endoscopic biopsy sampling and a concurrent CSF diversion procedure through a single bur hole and trajectory can be considered for intraventricular @entity5 . The overall success rates of 83% for the biopsy procedure and 86% for the ETV indicate that the procedures are beneficial in the majority of cases. A concordance rate of 75% was found in @entity1 who underwent an initial biopsy procedure and a subsequent microsurgical approach for @entity5 excision.
