Y-shaped Ventriculo-peritoneal Shunt for Adult Complicated Hydrocephalus: Report of 28 Illustrative Cases

Abstract

ObjectiveTo investigate the effectiveness of Y-shaped ventriculo-peritoneal shunt (VPS) (one abdominal tip connected with double or triple ventricular tips by one or two Y-shaped connectors) in the treatment of adult complicated hydrocephalus, we analyzed the long-term outcome and reported some illustrative cases.MethodsAmong 1,100 VPS surgeries between 2012 and 2017 in neurosurgery of Beijing Tiantan Hospital, twenty-eight (2.5%) adult patients with multiloculated hydrocephalus treated with Y-shaped shunt were analyzed.ResultsNineteen patients underwent Y-shaped VPS (bilateral frontal horn shunt) before or without tumor resection/stereotactic biopsy, 7 patients underwent Y-shaped VPS after tumor resection (5 bilateral and 2 triple shunts), and the other 2 patients underwent sequential bilateral VPS (unilateral VPS with additional contralateral ventricular tip by Y-shaped connector 6 months later). The one-year and two-year hydrocephalus-free survival rate for was both 88.7%. The one-year and two-year overall survival rate was both 66.7%. Cox regression confirmed that the OS is correlated with tumor grades. ConclusionsY-shaped VPS strategy is an easy and reliable option for multiloculated hydrocephalus, which can be used as the first choice for some indications.