DOI QR코드

DOI QR Code

A Novel Implantable Cerebrospinal Fluid Reservoir : A Pilot Study

  • Byun, Yoon Hwan (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Gwak, Ho Shin (Neuro-Oncology Clinic, Center for Specific Organs Center, National Cancer Center) ;
  • Kwon, Ji-Woong (Neuro-Oncology Clinic, Center for Specific Organs Center, National Cancer Center) ;
  • Kim, Kwang Gi (Department of Biomedical Engineering, Gachon University College of Medicine) ;
  • Shin, Sang Hoon (Neuro-Oncology Clinic, Center for Specific Organs Center, National Cancer Center) ;
  • Lee, Seung Hoon (Department of Neurosurgery, Eulji Medical Center, Eulji University) ;
  • Yoo, Heon (Neuro-Oncology Clinic, Center for Specific Organs Center, National Cancer Center)
  • 투고 : 2018.04.30
  • 심사 : 2018.06.07
  • 발행 : 2018.09.01

초록

Objective : The purpose of this pilot study was to examine the safety and function of the newly developed cerebrospinal fluid (CSF) reservoir called the V-Port. Methods : The newly developed V-Port consists of a non-collapsible reservoir outlined with a titanium cage and a connector for the ventricular catheter to be assembled. It is designed to be better palpated and more durable to multiple punctures than the Ommaya reservoir. A total of nine patients diagnosed with leptomeningeal carcinomatosis were selected for V-Port insertion. Each patient was followed up for evaluation for a month after the operation. Results : The average operation time for V-Port insertion was 42 minutes and the average incision size was 6.6 cm. The surgical technique of V-Port insertion was found to be intuitive by all neurosurgeons who participated in the pilot study. There was no obstruction or leakage of the V-Port during intrathecal chemotherapy or CSF drainage. Also, there were no complications including post-operative intracerebral hemorrhage, infection and skin problems related to the V-Port. Conclusion : V-Port is a safe and an easy to use implantable CSF reservoir that addresses problems of other implantable CSF reservoirs. Further multicenter clinical trial is needed to prove the safety and the function of the V-Port.

키워드

참고문헌

  1. Al-Anazi A, Bernstein M : Modified stereotactic insertion of the Ommaya reservoir. Technical note. J Neurosurg 92 : 1050-1052, 2000 https://doi.org/10.3171/jns.2000.92.6.1050
  2. Gwak HS, Lee CH, Yang HS, Joo J, Shin SH, Yoo H, et al. : Chemoport with a non-collapsible chamber as a replacement for an Ommaya reservoir in the treatment of leptomeningeal carcinomatosis. Acta Neurochir (Wien) 153 : 1971-1978; discussion 1978, 2011 https://doi.org/10.1007/s00701-011-1086-2
  3. Hyun JW, Jeong IH, Joung A, Cho HJ, Kim SH, Kim HJ : Leptomeningeal metastasis: clinical experience of 519 cases. Eur J Cancer 56 : 107-114, 2016 https://doi.org/10.1016/j.ejca.2015.12.021
  4. Kak M, Nanda R, Ramsdale EE, Lukas RV : Treatment of leptomeningeal carcinomatosis: current challenges and future opportunities. J Clin Neurosci 22 : 632-637, 2015 https://doi.org/10.1016/j.jocn.2014.10.022
  5. Mack F, Baumert BG, Schafer N, Hattingen E, Scheffler B, Herrlinger U, et al. : Therapy of leptomeningeal metastasis in solid tumors. Cancer Treat Rev 43 : 83-91, 2016 https://doi.org/10.1016/j.ctrv.2015.12.004
  6. Pace A, Fabi A : Chemotherapy in neoplastic meningitis. Crit Rev Oncol Hematol 60 : 194-200, 2006 https://doi.org/10.1016/j.critrevonc.2006.06.013
  7. Wang N, Bertalan MS, Brastianos PK : Leptomeningeal metastasis from systemic cancer: review and update on management. Cancer 124 : 21-35, 2018 https://doi.org/10.1002/cncr.30911

피인용 문헌

  1. Efficacy of Slow Rate Ventriculolumbar Perfusion Chemotherapy for Leptomeningeal Carcinomatosis: Interim Result of a Phase II Study vol.7, pp.2, 2018, https://doi.org/10.14791/btrt.2019.7.e33