دورية أكاديمية
Placement of Ommaya Reservoirs Using Electromagnetic Neuronavigation and Neuroendoscopy: A Retrospective Study with Cost-Benefit Analysis
| العنوان: | Placement of Ommaya Reservoirs Using Electromagnetic Neuronavigation and Neuroendoscopy: A Retrospective Study with Cost-Benefit Analysis |
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| المؤلفون: | Wang, Arthur, Tenner, Michael S., Schmidt, Meic H., Bowers, Christian |
| المصدر: | NYMC Faculty Publications |
| بيانات النشر: | Touro Scholar |
| سنة النشر: | 2019 |
| المجموعة: | Touro College & University System: Touro Scholar |
| مصطلحات موضوعية: | Cost-benefit analysis, Electromagnetic neuronavigation, Frameless stereotaxy, Neuroendoscopy, Ommaya reservoir, Ventricular catheter, Medicine and Health Sciences |
| الوصف: | BACKGROUND: Placement of intraventricular catheters in oncology patients is associated with high complication rates. Placing Ommaya reservoirs with the zero-error precision protocol (ZEPP), a combination of neuronavigation (AxiEM stereotactic navigation) and direct verification of catheter tip placement with a flexible neuroendoscope, is associated with decreased complication rates as a result of increased catheter placement accuracy. However, the ZEPP costs more than traditional methods of catheter placement, and the question of whether this increased accuracy with the ZEPP is cost-effective is unknown. METHODS: We performed a single-center retrospective chart review of 50 consecutive ommaya reservoir patient placements between 2010 and 2017. Twenty-five ventricular catheters were placed using the ZEPP protocol, and 25 ventricular catheters were placed using only AxiEM stealth navigation. Postoperative catheter accuracy and complication rates were assessed. A cost-benefit analysis was then conducted to determine if the overall cost for placing Ommaya reservoirs with the ZEPP was effective compared with the alternative method of using neuronavigation alone. RESULTS: In the non-ZEPP cohort, 10 of 25 catheters were placed within the optimal location compared with 25 of 25 catheters placed in the ZEPP cohort. Three complications occurred in the non-ZEPP cohort: 2 malpositioned catheters required surgical revision and 1 catheter-related hemorrhage resulted in a prolonged stay in the intensive care unit. No complications occurred in the ZEPP cohort. A cost-benefit analysis showed $4784 savings per patient with ZEPP utilization because of the high complication-associated costs. CONCLUSIONS: Implementation of the ZEPP for verifying ventricular catheter placement in Ommaya reservoirs improved catheter tip accuracy, resulted in lower complication rates, and was more cost-effective when compared with the non-ZEPP cohort, which used only neuronavigation. The ZEPP can be used for ventricular shunt catheter placement to ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| العلاقة: | https://touroscholar.touro.edu/nymc_fac_pubs/1974Test; https://doi.org/10.1016/j.wneu.2018.10.127Test |
| DOI: | 10.1016/j.wneu.2018.10.127 |
| الإتاحة: | https://doi.org/10.1016/j.wneu.2018.10.127Test https://touroscholar.touro.edu/nymc_fac_pubs/1974Test |
| رقم الانضمام: | edsbas.508613C6 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.wneu.2018.10.127 |
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