Lumboperitoneal and Ventriculoperitoneal Shunt Surgery for Posthemorrhagic Communicating Hydrocephalus: A Comparison

Wang, Zhanpeng; Wang, Ke; Qian, Zhouqi; Zeng, Li; Gao, Liang

doi:10.1016/j.wneu.2019.03.235

Cited by 21 publications

(15 citation statements)

References 35 publications

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“…A retrospective study recently indicated patients with PHH treated by LPS and VPS obtained equal clinical outcomes. [ 2 ] However, the best treatment still remains controversial. [ 20 ] In this regard, we conducted a prospective, randomized controlled trial to compare the safety and efficacy of VPS cohort with that of LPS cohort with PHH.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ventriculoperitoneal shunt to lumboperitoneal shunt in the treatment of posthemorrhagic hydrocephalus

You¹,

Ma²,

Yuan³

et al. 2020

Medicine

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Background: Ventriculoperitoneal shunt (VPS) surgery remains the most widely accepted and used option method to treat post-hemorrhagic hydrocephalus (PHH) worldwide while lumboperitoneal shunt (LPS) serves as an effectively alternative treatment. However, the outcomes of VPS and LPS in the treatment of PHH have not been compared in a prospective trial. Methods and design: In this monocentric, assessor-blinded, non-randomized controlled trial, 75 eligible patients with PHH for each group will be recruited to compare the outcomes of VPS cohort with that of LPS cohort. Each participant is evaluated before surgery, at the time of discharge, 3, and 6 months after surgery by experienced and practiced assessors. The primary outcome is the rate of shunt failure 6 months after shunt surgery. The secondary measure of efficacy is National Institute of Health stroke scale, together along with Glasgow coma scale, modified Rankin Scale, and Evans index at the evaluation point. A favorable outcome is defined as shunt success with an improvement of more than 1 point in the National Institute of Health stroke scale. Complication events occurring within 6 months after surgery are investigated. A serious adverse events throughout the study are recorded regarding the safety of shunts. Discussion: The results of this trial will provide evidence for the treatment options for patients with PHH.

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Section: Discussionmentioning

confidence: 99%

Comparison of ventriculoperitoneal shunt to lumboperitoneal shunt in the treatment of posthemorrhagic hydrocephalus

You¹,

Ma²,

Yuan³

et al. 2020

Medicine

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“…Besides, the indications for performing LPS have recently broadened to other communicating types of hydrocephalus, including PHH ( 8 , 9 ). Wang et al ( 10 ) recently found that patients with PHH treated by LPS or VPS obtained equal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Association of Preoperative Cerebrospinal Fluids Parameters With Early Shunt Obstruction in Patients With Post-hemorrhagic Hydrocephalus Treated by Lumboperitoneal Shunt

et al. 2021

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Background: Early shunt obstruction (SO) remains the most common cause of lumboperitoneal shunt (LPS) failure. Although there is anecdotal evidence that the level of cerebrospinal fluid (CSF) parameters might affect shunt performance, its association with early LPS obstruction in adults with post-hemorrhagic hydrocephalus (PHH) is unclear.Methods: The retrospective study was performed by reviewing the adults with PHH treated by LPS from years 2014 to 2018. We included patients with CSF samples analyzed within 1 week prior to shunt insertion or at the time of shunt insertion. Baseline characteristics of each patient were collected. The primary outcomes were the incidence rate and associated factors of SO occurring within 3 months of shunt placement. The secondary outcomes included scores on the National Institute of Health Stroke Scale (NIHSS) and Evans Index at discharge.Results: A total of 76 eligible patients were analyzed, of whom 61 were obstruction-free and 15 were early SO. The overall rate of early SO was 15.6%. The RBCs count and nucleated cells count in preoperative CSF were actually higher in patients with early SO, compared to patients in the control group. Multivariate analysis identified RBC elevation (>0 × 106/L; OR: 10.629, 95% CI: 1.238–91.224, p = 0.031) as a dependent risk factor for early SO. NIHSS dramatically decreased at discharge while the alteration of ventricular size was not observed.Conclusions: This study suggested that the presence of RBCs in preoperative CSF was associated with early SO in patients with PHH treated by LPS.

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“…Early evidence had ever revealed LPS was more likely to undergo shunt failure compared with VPS (7% vs 1%) while a recent retrospective study suggested patients with communicating hydrocephalus secondary to ICH treated by VPS or LPS had equivalent clinical results. 14 18 In addition, Giordan et al 19 recently performed a systematic review and meta-analysis, suggesting the shunting outcomes did not differ significantly among different CSF diversion techniques used. However, there is lack of high-quality studies comparing these two techniques in order to certain the benefits and harms to use one of these two methods.…”

Section: Introductionmentioning

confidence: 99%

Shunting outcomes in communicating hydrocephalus: protocol for a multicentre, open-label, randomised controlled trial

et al. 2021

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IntroductionVentriculoperitoneal shunt (VPS) remains the most widely used methods to treat communicating hydrocephalus. More recently, lumboperitoneal shunt (LPS) has been suggested as a reasonable option in some studies. However, there is lack of high-quality studies comparing these two techniques in order to certain the benefits and harms to use one of these two methods. The purpose of the current study is to determine the effectiveness and safety of the LPS versus the VPS in patients with communicating hydrocephalus.Methods and analysisAll eligible patients aged 18–90 years with communicating hydrocephalus will be recruited and then randomly allocated into LPS or VPS group in a ratio of 1:1. All patients will be analysed before shunt insertion, at the time of discharge, 1 month, 6 months, 12 months and 24 months postoperatively. The primary outcome measure is the rate of shunt failure at a 2-year follow-up term. The secondary outcomes include Keifer’s Hydrocephalus Scale, National Institute of Health Stroke Scale, Glasgow Outcome Scale Extended, Evans index, safety endpoints and cost-effectiveness of hospital stay.Ethics and disseminationThe study will be performed in compliance with the Declaration of Helsinki (2002) of the World Medical Association. The study was approved by Institutional Review Board of West China Hospital. All patients will be fully informed the potential benefits, potential risks and responsibilities, those who will sign the informed consents once they are included. Preliminary and final results will be published in peer-reviewed journals and presented at national and international congresses.Trial registration numberChiCTR2100043839.

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Lumboperitoneal and Ventriculoperitoneal Shunt Surgery for Posthemorrhagic Communicating Hydrocephalus: A Comparison

Cited by 21 publications

References 35 publications

Comparison of ventriculoperitoneal shunt to lumboperitoneal shunt in the treatment of posthemorrhagic hydrocephalus

Comparison of ventriculoperitoneal shunt to lumboperitoneal shunt in the treatment of posthemorrhagic hydrocephalus

Association of Preoperative Cerebrospinal Fluids Parameters With Early Shunt Obstruction in Patients With Post-hemorrhagic Hydrocephalus Treated by Lumboperitoneal Shunt

Shunting outcomes in communicating hydrocephalus: protocol for a multicentre, open-label, randomised controlled trial

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