Endoscopic lavage for the treatment of multiple shunt failures in children

Abstract

AIM:To compare the efficacy of neuroendoscopic lavage (NEL) and shunt revision (SR) in the treatment of multiple shunt failures in children with hydrocephalus. MATERIAL and METHODS:The data of 56 pediatric patients who underwent surgeries for the treatment of shunt failure were retrospectively reviewed. Patients were divided into two groups, i.e., the simple SR (Group A) and the NEL+SR (Group B) cohorts. Demographic characteristics, co-morbidities, surgical interventions, cerebrospinal fluid analyzes, and complications were recorded and statistically compared between the groups. RESULTS: Among the 56 enrolled patients, 51 presented with shunt dysfunction caused by infectious debris or clots at different times. Moreover, 28 of these 51 patients (54.9%) were female and 23 (45%) were male. The mean age was 7.3 months. Simple SR was performed in 30 cases (Group A), and NEL and simultaneous SR were performed in 21 patients (Group B). The risk of shunt dysfunction was significantly lower in Group B (p<0.05).The risk of infection was elevated in Group A; however, this difference was not statistically significant (p>0.05).CONCLUSION: Simultaneous endoscopic lavage and SR was an effective method for the treatment of shunt dysfunction in children. It was also superior to simple SR regarding the risk of shunt dysfunction. Additional clinical studies are needed to verify this outcome.