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array:23 [ "pii" => "S1130147399707657" "issn" => "11301473" "doi" => "10.1016/S1130-1473(99)70765-7" "estado" => "S300" "fechaPublicacion" => "1999-01-01" "aid" => "70765" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "1999" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 1999;10:439-44" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1949 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 1045 "PDF" => 887 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147399707669" "issn" => "11301473" "doi" => "10.1016/S1130-1473(99)70766-9" "estado" => "S300" "fechaPublicacion" => "1999-01-01" "aid" => "70766" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Neurocirugia. 1999;10:444" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7456 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 3703 "PDF" => 3736 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Comentario" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "444" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Esparza" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Esparza" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399707669?idApp=UINPBA00004B" "url" => "/11301473/0000001000000006/v1_201305151018/S1130147399707669/v1_201305151018/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1130147399707645" "issn" => "11301473" "doi" => "10.1016/S1130-1473(99)70764-5" "estado" => "S300" "fechaPublicacion" => "1999-01-01" "aid" => "70764" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 1999;10:426-38" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 12579 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 2393 "PDF" => 10169 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Fracturas de la apófisis odontoides: Revisión de nuestra casuística, implicaciones terapéuticas y nueva clasificación" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "426" "paginaFinal" => "438" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Odontoid fractures. A review and new classification" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "S. Martín-Ferrer, J. Rimbau, M<span class="elsevierStyleSup">a</span>.C. Joly" "autores" => array:3 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Martín-Ferrer" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Rimbau" ] 2 => array:2 [ "nombre" => "M<span class="elsevierStyleSup">a</span>.C." "apellidos" => "Joly" ] ] ] 1 => array:2 [ "autoresLista" => "J. Teruel, J. Pont" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Teruel" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Pont" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399707645?idApp=UINPBA00004B" "url" => "/11301473/0000001000000006/v1_201305151018/S1130147399707645/v1_201305151018/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Neuroendoscopia: La otra cara de la moneda Un estudio sobre la eficiencia económica de esta técnica en el tratamiento de la hidrocefalia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "439" "paginaFinal" => "444" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J. Ibáñez, L. Caral, J. Enseñat, E. Ferrer" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Ibáñez" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Caral" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Enseñat" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Ferrer" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Clínic i Provincial. Universitat de Barcelona. Barcelona" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neuroendoscopy. The other side of the coin A study of the economical efficiency of this technique in the treatment of hydrocephalus" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec156816" "palabras" => array:4 [ 0 => "Hidrocefalia" 1 => "Ventriculostomía endoscópica" 2 => "Neuroendoscopia" 3 => "Recursos sanitarios" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156817" "palabras" => array:4 [ 0 => "Hydrocephalus" 1 => "Endoscopic third ventriculostomy" 2 => "Neuroendoscopy" 3 => "Health care resources" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluación de la utilización y eficiencia económica de las técnicas neuroendoscópicas en el tratamiento de la hidrocefalia en nuestro Servicio de Neurocirugía durante un período de cinco años.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Entre Enero de 1993 y Diciembre de 1997, fueron operados 298 pacientes en nuestro Servicio de Neurocirugía por presentar algún tipo de hidrocefalia. Ciento ocho enfermos fueron tratados únicamente mediante la colocación de una derivación ventricular externa y han sido excluidos del análisis. Los restantes 190 pacientes fueron tratados mediante sistemas derivativos internos de líquido cefalorraquídeo permanentes (132 enfermos-69.5%) o mediante el uso de diversas técnicas neuroendoscópicas (58 pacientes-30.5%). Todos estos pacientes han sido estudiados retrospectivamente recogiéndose en ellos diferentes variables a fin de establecer el grado de eficiencia económica de la introducción de la neuroendoscopia en nuestro Servicio.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En el grupo de pacientes tratados mediante una derivación convencional, el 87.1% presentaban una hidrocefalia comunicante siendo la hidrocefalia crónica idiopática del adulto la principal causa. Entre los pacientes tratados con técnicas endoscópicas, el 96.6% padecían una hidrocefalia no comunicante teniendo como principal etiología la obstrucción tumoral. Los resultados obtenidos muestran que, con una tasa de éxito global del 82.7%, la endoscopia ha evitado la colocación de 48 derivaciones internas de líquido cefalorraquídeo cuyo coste, sólo en material protésico, amortiza la inversión realizada en la adquisición del equipo de neuroendoscopia. Por otro lado, realizando un cálculo estimativo a partir del grupo de pacientes tratados mediante derivaciones internas de líquido cefalorraquídeo, el uso de técnicas neuroendoscópicas ha ahorrado durante el período en estudio 100 días de estancia hospitalaria, evitando 8 reingresos y 9 intervenciones quirúrgicas por complicaciones de estos dispositivos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las técnicas neuroendoscópicas son útiles en el tratamiento de casi un tercio de las hidrocefalias en un centro neuroquirúrgico de adultos aunque el implante de una derivación interna sigue siendo la intervención quirúrgica más frecuente en el tratamiento de la hidrocefalia. Sin embargo, en los Servicios de Neurocirugía en los cuales se practique un alto número de intervenciones por esta patología, la inversión en equipamiento y formación neuroendoscópica, es altamente rentable a medio plazo, liberando recursos para otras necesidades.</p>" ] "en" => array:2 [ "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.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Between January 1993 and December 1997, 298 patients were operated on in our Neurosurgical Department for sorne kind of hydrocephalus. One hundred and eight patients were managed only with an external ventricular drainage, and they have been excluded from the analysis. The other 190 patients were treated with internal cerebrospinal fluid shunts (132 patients-69.5%), or by means of diverse neuroendoscopic techniques (58 patients-30.5%). All these patients have been retrospectively studied, collecting different variables with the aim of establishing the grade of economical efficiency of the introduction of neuroendoscopy in our Department.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In the group of patients treated with a conventional shunt, 87.1% presented with a communicanting hydrocephalus, being the chronic idiopathic adult-onset hydrocephalus the main cause. Of the patients treated endoscopically, 96.6% suffered from a non-communicanting hydrocephalus, with the tumoral obstruction as main etiology. The results show that, with a global succesful rate of 82.7% endoscopic techniques have avoided the implantation of 48 internal shunt devices. The investment in neuroendoscopical equipment is amortized by the saving in prothesic material. On the other side, an estimative calculation from the group of patients treated with internal shunts, shows that the use of neuroendoscopical techniques has saved during this period 100 hospitalisation days, avoiding 8 readmissions and 9 operations for complications of those devices.</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's Neurosurgical Department. The implantation of an internal shunt device, though, is yet the most frequent surgical procedure in the management of this condition. However, in Neurosurgical Departments where a high number of surgical procedures for this disease are performed, the instruction and investment in neuroendoscopic equipment are highly cost-effective in a medium term, releasing resources for other requirements.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Ibáñez Domínguez, J.; Caral Pons, L.; Enseñat Nora, J.; Ferrer Rodríguez, E.: Neuroendoscopia: la otra cara de la moneda. Un estudio sobre la eficiencia económica de esta técnica en el tratamiento de la hidrocefalia. Neurocirugía 1999; 10: 439–444.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic neurosurgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.M. Auer" 1 => "P. Holzer" 2 => "P.W. Ascher" 3 => "F. Heppner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Acta Neurochir. (Wien)" "fecha" => "1998" "volumen" => "90" "paginaInicial" => "114" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An economic argument in favour of endoscopic third ventriculostomy as a treatment for obstructive hydrocephalus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Barlow" 1 => "H.S. Ching" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Minim. Invas. Neurosurg." "fecha" => "1997" "volumen" => "40" "paginaInicial" => "37" "paginaFinal" => "39" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frequency and causes of shunt revisions in different cerebrospinal fluid shunt types" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B.M. Borgbjerg" 1 => "F. Gjerris" 2 => "M.J. Albeck" 3 => "J. Hauerberg" 4 => "S.E. Borgesen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir. (Wien)" "fecha" => "1995" "volumen" => "136" "paginaInicial" => "189" "paginaFinal" => "194" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ventriculoscopic surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.R. Cohen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin. Neurosurg." "fecha" => "1994" "volumen" => "41" "paginaInicial" => "546" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7842623" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.E. Dandy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "paginaInicial" => "189" "paginaFinal" => "190" "serieVolumen" => "33" "serieTitulo" => "Cerebral ventriculoscopy" "serieFecha" => "1922" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Davis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Neurological Surgery" "paginaInicial" => "438" "paginaFinal" => "447" "serieFecha" => "1939" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ventriculofiberscope: a new technique for endoscopic diagnosis and operation. Technical note" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Fukushima" 1 => "B. Ishijima" 2 => "K. Hirakawa" 3 => "N. Nakamura" 4 => "K. Sano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1973.38.2.0251" "Revista" => array:7 [ "tituloSerie" => "J. Neurosurg." "fecha" => "1973" "volumen" => "38" "paginaInicial" => "251" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4694225" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109702016856" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manual of endoscopic proceclures in Neurosurgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.A. Grotenhuis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1995" "editorial" => "Uitgeverij Machaon" "editorialLocalizacion" => "Nijmegen" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.F.C. Jones" 1 => "B.C. Kwok" 2 => "M. Stening" 3 => "M. Vonun" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Minim. Invas. Neurosurg." "fecha" => "1994" "volumen" => "37" "paginaInicial" => "28" "paginaFinal" => "36" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Third ventriculostomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Saint-Rose" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Neuroendoscopy" "paginaInicial" => "47" "paginaFinal" => "62" "serieFecha" => "1992" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shunt complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.M. Scott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Neurosurgery" "paginaInicial" => "3.655" "paginaFinal" => "3.664" "serieFecha" => "1996" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An endoscopic technique for third ventriculostomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.K. Vries" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg. Neurol." "fecha" => "1978" "volumen" => "9" "paginaInicial" => "165" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/635761" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/11301473/0000001000000006/v1_201305151018/S1130147399707657/v1_201305151018/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001000000006/v1_201305151018/S1130147399707657/v1_201305151018/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399707657?idApp=UINPBA00004B" ]
