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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluaci&#243;n de la utilizaci&#243;n y eficiencia econ&#243;mica de las t&#233;cnicas neuroendosc&#243;picas en el tratamiento de la hidrocefalia en nuestro Servicio de Neurocirug&#237;a durante un per&#237;odo de cinco a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Entre Enero de 1993 y Diciembre de 1997&#44; fueron operados 298 pacientes en nuestro Servicio de Neurocirug&#237;a por presentar alg&#250;n tipo de hidrocefalia&#46; Ciento ocho enfermos fueron tratados &#250;nicamente mediante la colocaci&#243;n de una derivaci&#243;n ventricular externa y han sido excluidos del an&#225;lisis&#46; Los restantes 190 pacientes fueron tratados mediante sistemas derivativos internos de l&#237;quido cefalorraqu&#237;deo permanentes &#40;132 enfermos-69&#46;5&#37;&#41; o mediante el uso de diversas t&#233;cnicas neuroendosc&#243;picas &#40;58 pacientes-30&#46;5&#37;&#41;&#46; Todos estos pacientes han sido estudiados retrospectivamente recogi&#233;ndose en ellos diferentes variables a fin de establecer el grado de eficiencia econ&#243;mica de la introducci&#243;n de la neuroendoscopia en nuestro Servicio&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el grupo de pacientes tratados mediante una derivaci&#243;n convencional&#44; el 87&#46;1&#37; presentaban una hidrocefalia comunicante siendo la hidrocefalia cr&#243;nica idiop&#225;tica del adulto la principal causa&#46; Entre los pacientes tratados con t&#233;cnicas endosc&#243;picas&#44; el 96&#46;6&#37; padec&#237;an una hidrocefalia no comunicante teniendo como principal etiolog&#237;a la obstrucci&#243;n tumoral&#46; Los resultados obtenidos muestran que&#44; con una tasa de &#233;xito global del 82&#46;7&#37;&#44; la endoscopia ha evitado la colocaci&#243;n de 48 derivaciones internas de l&#237;quido cefalorraqu&#237;deo cuyo coste&#44; s&#243;lo en material prot&#233;sico&#44; amortiza la inversi&#243;n realizada en la adquisici&#243;n del equipo de neuroendoscopia&#46; Por otro lado&#44; realizando un c&#225;lculo estimativo a partir del grupo de pacientes tratados mediante derivaciones internas de l&#237;quido cefalorraqu&#237;deo&#44; el uso de t&#233;cnicas neuroendosc&#243;picas ha ahorrado durante el per&#237;odo en estudio 100 d&#237;as de estancia hospitalaria&#44; evitando 8 reingresos y 9 intervenciones quir&#250;rgicas por complicaciones de estos dispositivos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las t&#233;cnicas neuroendosc&#243;picas son &#250;tiles en el tratamiento de casi un tercio de las hidrocefalias en un centro neuroquir&#250;rgico de adultos aunque el implante de una derivaci&#243;n interna sigue siendo la intervenci&#243;n quir&#250;rgica m&#225;s frecuente en el tratamiento de la hidrocefalia&#46; Sin embargo&#44; en los Servicios de Neurocirug&#237;a en los cuales se practique un alto n&#250;mero de intervenciones por esta patolog&#237;a&#44; la inversi&#243;n en equipamiento y formaci&#243;n neuroendosc&#243;pica&#44; es altamente rentable a medio plazo&#44; liberando recursos para otras necesidades&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluation of the utilization and the economical efficiency of the neuroendoscopic techniques in the treatment of hydrocephalus in our Neurosurgical Department during a five-year period&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Between January 1993 and December 1997&#44; 298 patients were operated on in our Neurosurgical Department for sorne kind of hydrocephalus&#46; One hundred and eight patients were managed only with an external ventricular drainage&#44; and they have been excluded from the analysis&#46; The other 190 patients were treated with internal cerebrospinal fluid shunts &#40;132 patients-69&#46;5&#37;&#41;&#44; or by means of diverse neuroendoscopic techniques &#40;58 patients-30&#46;5&#37;&#41;&#46; All these patients have been retrospectively studied&#44; collecting different variables with the aim of establishing the grade of economical efficiency of the introduction of neuroendoscopy in our Department&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In the group of patients treated with a conventional shunt&#44; 87&#46;1&#37; presented with a communicanting hydrocephalus&#44; being the chronic idiopathic adult-onset hydrocephalus the main cause&#46; Of the patients treated endoscopically&#44; 96&#46;6&#37; suffered from a non-communicanting hydrocephalus&#44; with the tumoral obstruction as main etiology&#46; The results show that&#44; with a global succesful rate of 82&#46;7&#37; endoscopic techniques have avoided the implantation of 48 internal shunt devices&#46; The investment in neuroendoscopical equipment is amortized by the saving in prothesic material&#46; On the other side&#44; an estimative calculation from the group of patients treated with internal shunts&#44; shows that the use of neuroendoscopical techniques has saved during this period 100 hospitalisation days&#44; avoiding 8 readmissions and 9 operations for complications of those devices&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Neuroendoscopic techniques are useful in the management of almost one third of the cases of hydrocephalus in an adult&#39;s Neurosurgical Department&#46; The implantation of an internal shunt device&#44; though&#44; is yet the most frequent surgical procedure in the management of this condition&#46; However&#44; in Neurosurgical Departments where a high number of surgical procedures for this disease are performed&#44; the instruction and investment in neuroendoscopic equipment are highly cost-effective in a medium term&#44; releasing resources for other requirements&#46;</p>"
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Neuroendoscopia: La otra cara de la moneda Un estudio sobre la eficiencia económica de esta técnica en el tratamiento de la hidrocefalia
Neuroendoscopy. The other side of the coin A study of the economical efficiency of this technique in the treatment of hydrocephalus
J. Ibáñez, L. Caral, J. Enseñat, E. Ferrer
Servicio de Neurocirugía. Hospital Clínic i Provincial. Universitat de Barcelona. Barcelona
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluaci&#243;n de la utilizaci&#243;n y eficiencia econ&#243;mica de las t&#233;cnicas neuroendosc&#243;picas en el tratamiento de la hidrocefalia en nuestro Servicio de Neurocirug&#237;a durante un per&#237;odo de cinco a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Entre Enero de 1993 y Diciembre de 1997&#44; fueron operados 298 pacientes en nuestro Servicio de Neurocirug&#237;a por presentar alg&#250;n tipo de hidrocefalia&#46; Ciento ocho enfermos fueron tratados &#250;nicamente mediante la colocaci&#243;n de una derivaci&#243;n ventricular externa y han sido excluidos del an&#225;lisis&#46; Los restantes 190 pacientes fueron tratados mediante sistemas derivativos internos de l&#237;quido cefalorraqu&#237;deo permanentes &#40;132 enfermos-69&#46;5&#37;&#41; o mediante el uso de diversas t&#233;cnicas neuroendosc&#243;picas &#40;58 pacientes-30&#46;5&#37;&#41;&#46; Todos estos pacientes han sido estudiados retrospectivamente recogi&#233;ndose en ellos diferentes variables a fin de establecer el grado de eficiencia econ&#243;mica de la introducci&#243;n de la neuroendoscopia en nuestro Servicio&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el grupo de pacientes tratados mediante una derivaci&#243;n convencional&#44; el 87&#46;1&#37; presentaban una hidrocefalia comunicante siendo la hidrocefalia cr&#243;nica idiop&#225;tica del adulto la principal causa&#46; Entre los pacientes tratados con t&#233;cnicas endosc&#243;picas&#44; el 96&#46;6&#37; padec&#237;an una hidrocefalia no comunicante teniendo como principal etiolog&#237;a la obstrucci&#243;n tumoral&#46; Los resultados obtenidos muestran que&#44; con una tasa de &#233;xito global del 82&#46;7&#37;&#44; la endoscopia ha evitado la colocaci&#243;n de 48 derivaciones internas de l&#237;quido cefalorraqu&#237;deo cuyo coste&#44; s&#243;lo en material prot&#233;sico&#44; amortiza la inversi&#243;n realizada en la adquisici&#243;n del equipo de neuroendoscopia&#46; Por otro lado&#44; realizando un c&#225;lculo estimativo a partir del grupo de pacientes tratados mediante derivaciones internas de l&#237;quido cefalorraqu&#237;deo&#44; el uso de t&#233;cnicas neuroendosc&#243;picas ha ahorrado durante el per&#237;odo en estudio 100 d&#237;as de estancia hospitalaria&#44; evitando 8 reingresos y 9 intervenciones quir&#250;rgicas por complicaciones de estos dispositivos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las t&#233;cnicas neuroendosc&#243;picas son &#250;tiles en el tratamiento de casi un tercio de las hidrocefalias en un centro neuroquir&#250;rgico de adultos aunque el implante de una derivaci&#243;n interna sigue siendo la intervenci&#243;n quir&#250;rgica m&#225;s frecuente en el tratamiento de la hidrocefalia&#46; Sin embargo&#44; en los Servicios de Neurocirug&#237;a en los cuales se practique un alto n&#250;mero de intervenciones por esta patolog&#237;a&#44; la inversi&#243;n en equipamiento y formaci&#243;n neuroendosc&#243;pica&#44; es altamente rentable a medio plazo&#44; liberando recursos para otras necesidades&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluation of the utilization and the economical efficiency of the neuroendoscopic techniques in the treatment of hydrocephalus in our Neurosurgical Department during a five-year period&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Between January 1993 and December 1997&#44; 298 patients were operated on in our Neurosurgical Department for sorne kind of hydrocephalus&#46; One hundred and eight patients were managed only with an external ventricular drainage&#44; and they have been excluded from the analysis&#46; The other 190 patients were treated with internal cerebrospinal fluid shunts &#40;132 patients-69&#46;5&#37;&#41;&#44; or by means of diverse neuroendoscopic techniques &#40;58 patients-30&#46;5&#37;&#41;&#46; All these patients have been retrospectively studied&#44; collecting different variables with the aim of establishing the grade of economical efficiency of the introduction of neuroendoscopy in our Department&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In the group of patients treated with a conventional shunt&#44; 87&#46;1&#37; presented with a communicanting hydrocephalus&#44; being the chronic idiopathic adult-onset hydrocephalus the main cause&#46; Of the patients treated endoscopically&#44; 96&#46;6&#37; suffered from a non-communicanting hydrocephalus&#44; with the tumoral obstruction as main etiology&#46; The results show that&#44; with a global succesful rate of 82&#46;7&#37; endoscopic techniques have avoided the implantation of 48 internal shunt devices&#46; The investment in neuroendoscopical equipment is amortized by the saving in prothesic material&#46; On the other side&#44; an estimative calculation from the group of patients treated with internal shunts&#44; shows that the use of neuroendoscopical techniques has saved during this period 100 hospitalisation days&#44; avoiding 8 readmissions and 9 operations for complications of those devices&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Neuroendoscopic techniques are useful in the management of almost one third of the cases of hydrocephalus in an adult&#39;s Neurosurgical Department&#46; The implantation of an internal shunt device&#44; though&#44; is yet the most frequent surgical procedure in the management of this condition&#46; However&#44; in Neurosurgical Departments where a high number of surgical procedures for this disease are performed&#44; the instruction and investment in neuroendoscopic equipment are highly cost-effective in a medium term&#44; releasing resources for other requirements&#46;</p>"
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ISSN: 11301473
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