A Retrospective Analysis of Ventriculoperitoneal Shunt Revision Cases of a Single Institute

Park, Man-Kyu; Kim, Myung-Soo; Park, Ki‐Su; Park, Seong‐Hyun; Hwang, Jeong-In; Hwang, Seung-Hyun

doi:10.3340/jkns.2015.57.5.359

Cited by 45 publications

(32 citation statements)

References 35 publications

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“…Recently, some researches showed antibioticimpregnated shunt catheters can reduce the infection rate significantly, but still controversy. Postoperative shunt infections were reported occur in 0.3-17% [2,3] of cases in most neurosurgical institutes.…”

Section: Discussionmentioning

confidence: 99%

Shunt infection in a single institute: a retrospective study

2018

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Background: Shunt infection (SI) is a dreaded and major complication in the management of hydrocephalus after cerebral fluid shunts. We reviewed retrospectively shunted for hydrocephalus during the last 2 years to evaluate the incidence of SI, including the risk factors and types of infection. Methods: Patients who had undergone a shunt operation from January 2013 to December 2014 in our hospital were observed, study clinical data and a 6-24 months follow-up. Patients with infection complications were found and investigated. Results: Among 343 cases of shunt surgery performed in our hospital, 6-24 months follow-up was done. 13 patients (10 men and 3 women) were found shunt infections, 11 (3.7%) were post-operation of ventriculo-peritoneal shunt and 2 (4.2%) of lumbo-peritoneal shunt.92.3% cases of shunt infections were present within 2 months after shunt surgery, gram positive cocci accounted for 90% of the bacteria. After different surgery and antibiotic treatment, 8 patients became better and 5 worse. Conclusions: The data in our single institution shows no significant differences between sex and shunt surgery. Infections more likely to present within the first 2 months after shunt placement, and gram-positive cocci account for a great proportion in detected bacteria.

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Section: Discussionmentioning

confidence: 99%

Shunt infection in a single institute: a retrospective study

2018

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“…1,10,13,25,28,29,37,38,40,41,50 In our study, we identified other problems associated with shunt calcification. These include fibrosis and tethering to the skin, causing localized discomfort to the patients (Fig.…”

Section: Tethering and Tract Fibrosismentioning

confidence: 74%

“…2,8,26,32,37,[47][48][49] At present, there are several publications addressing pediatric VPS failure and/or its associated complications. However, we note that the majority of such literature tends to focus on early complicationsusually where the VPS fails within 1 or 2 years postoperatively.…”

Section: Neurosurg Focus 41 (5):e7 2016mentioning

confidence: 99%

Late pediatric ventriculoperitoneal shunt failures: a Singapore tertiary institution's experience

Lee

Low

et al. 2016

FOC

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OBJECTIVE The introduction of ventriculoperitoneal shunts changed the way hydrocephalus was treated. Whereas much is known about the causes of shunt failure in the first few years, there is a paucity of data in the literature regarding the cause of late shunt failures. The authors conducted a study to find out the different causes of late shunt failures in their institution. METHODS A 10-year retrospective study of all the patients who were treated in the authors' hospital between 2006 and 2015 was conducted. Late shunt failures included those in patients who had to undergo shunt revision more than 5 years after their initial shunt insertion. The patient's notes and scans were reviewed to obtain the age and sex of the patient, the time it took for the shunt to fail, the reason for failure, and the patient's follow-up. RESULTS Forty-six patients in the authors' institution experienced 48 late shunt failures in the last 10 years. Their ages ranged from 7 to 26 years (12.23 ± 4.459 years [mean ± SD]). The time it took for the shunts to fail was between 6 and 24 years (mean 10.25 ± 3.77 years). Reasons for failure resulting in shunt revision include shunt fracture in 24 patients (50%), shunt blockage in 14 patients (29.2%), tract fibrosis in 6 patients (12.5%), shunt dislodgement in 2 patients (4.2%), and shunt erosion in 2 patients (4.2%). Postoperative follow-up for the patients ranged from 6 to 138 months (mean 45.15 ± 33.26 months). CONCLUSIONS Late shunt failure is caused by the effects of aging on the shunt, and the complications are different from early shunt failure. A large proportion are complications associated with shunt calcification. The authors advocate a long follow-up for pediatric patients with shunts in situ to monitor them for various causes of late shunt failure.

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“…As mentioned above, to manage hydrocephalus in a posterior fossa tumor, CSF diversion, such as VP shunt, ETV, or EVD is used before craniotomy to reduce the ICP [3,9] . Currently, the VP shunt is not recommended because of shunt-associated complications [4] . Routine ETV before craniotomy has also been debated because of the low incidence of persistent hydrocephalus after mass resection [10] .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, many brain tumor surgeons perform several preoperative treatments, such as ventriculoperitoneal (VP) shunt, external ventricular drainage (EVD), or endoscopic 3rd ventriculostomy (ETV), which resolve the increased intracranial pressure (ICP) produced by hydrocephalus [1][2][3] . However, the VP shunt has been avoided because of device-associated complications [4] . Hence, EVD and ETV can usually be used to reduce ICP.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Tumoral Bleeding of Hypervascular Medulloblastoma after Ventricular Drainage: A Case Report

Ryu

Jung²,

Han³

et al. 2016

Pediatr Neurosurg

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We report a rare case of intraoperative tumoral bleeding of a hypervascular medulloblastoma. A 12-year-old girl presented with dizziness and nausea. Brain magnetic resonance (MR) images revealed an approximately 4.2-cm enhanced mass on the cerebellar vermis associated with mild perilesional edema and increased cerebral blood volume. Angiography showed tumoral staining and developed occipital and circular dural sinuses in the venous phase. A suboccipital craniotomy was performed. To relieve the intracranial pressure, cerebrospinal fluid (CSF) was drained via a lateral ventricular catheter in the occipital horn. During the opening of the dura, the brain swelling had progressed, and brain computed tomography revealed an intratumoral hemorrhage with brainstem compression. The patient was in a stuporous mental state. A reoperation was performed, and the mass was totally removed. The pathologic findings revealed a medulloblastoma with abnormal enlarged arterial vascular structures. Postoperatively, the patient recovered to an alert mental state. She underwent chemotherapy and radiotherapy. There was no recurrence after 1 year. Pre-resectional CSF drainage should not be routinely performed in posterior fossa tumors, especially with increased cerebral blood volume on MR perfusion images. Complete removal should be performed quickly while CSF drainage should be performed slowly. An intratumoral hemorrhage should be considered in posterior fossa tumors when severe brain swelling suddenly develops after CSF drainage.

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A Retrospective Analysis of Ventriculoperitoneal Shunt Revision Cases of a Single Institute

Cited by 45 publications

References 35 publications

Shunt infection in a single institute: a retrospective study

Shunt infection in a single institute: a retrospective study

Late pediatric ventriculoperitoneal shunt failures: a Singapore tertiary institution's experience

Intraoperative Tumoral Bleeding of Hypervascular Medulloblastoma after Ventricular Drainage: A Case Report

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