Placement of Ommaya Reservoirs Using Electromagnetic Neuronavigation and Neuroendoscopy: A Retrospective Study with Cost-Benefit Analysis.

摘要: Background Placement of intraventricular catheters in oncology patients is associated with high complication rates. Placing Ommaya reservoirs the zero-error precision protocol (ZEPP), a combination neuronavigation (AxiEM stereotactic navigation) and direct verification catheter tip placement flexible neuroendoscope, decreased rates as result increased accuracy. However, ZEPP costs more than traditional methods placement, question whether this accuracy cost-effective unknown. Methods We performed single-center retrospective chart review 50 consecutive ommaya reservoir patient placements between 2010 2017. Twenty-five ventricular were placed using protocol, 25 only AxiEM stealth navigation. Postoperative assessed. A cost-benefit analysis was then conducted to determine if overall cost for placing effective compared alternative method alone. Results In non-ZEPP cohort, 10 within optimal location cohort. Three complications occurred cohort: 2 malpositioned required surgical revision 1 catheter-related hemorrhage resulted prolonged stay intensive care unit. No showed $4784 savings per utilization because complication-associated costs. Conclusions Implementation verifying improved accuracy, lower rates, when which used neuronavigation. The can be shunt decrease verify or standard ventriculoperitoneal shunts.