脳室腹腔シャントを有する子宮体癌に対して腹腔鏡下手術を施行した２例

抄録

　Here we report on the management and outcomes of ventriculoperitoneal shunt (VPS) in uterine cancer patients undergoing MRI and subsequent laparoscopic surgery. VPS is crucial for hydrocephalus treatment, a cerebrovascular disease complication, by facilitating drainage from ventricles to the abdominal cavity. MRI scans in VPS patients necessitate neurosurgical consultation due to potential shunt dysfunction from altered valve pressure settings. We present two cases of uterine cancer patients with pre-existing VPS who underwent laparoscopic surgery following MRI diagnostics.

Case 1: An 81-year-old woman with normal pressure hydrocephalus treated with VPS. Post-MRI, she experienced a sudden headache attributed to a 90-degree counterclockwise valve rotation, resolved by valve adjustment. She was diagnosed with stage IB endometrial cancer and underwent successful laparoscopic surgery without VPS complications.

Case 2: A 73-year-old woman with hydrocephalus following intraventricular hemorrhage, treated with VPS. MRI was performed under neurosurgical guidance to ensure valve settings were correct; no abnormalities were detected. She was also diagnosed with stage IB endometrial cancer and underwent laparoscopic surgery without perioperative VPS complications.

Conclusion: These cases underscore the importance of neurosurgical consultation prior to MRI in VPS patients to prevent complications and ensure safe surgical outcomes.