Publication: Pediatric Ventriculoperitoneal Shunt: Outcome Analysis in a Tertiary Care Center in Nepal
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
ABSTRACT
Introduction: Ventriculoperitoneal (VP) shunt is a commonly performed neurosurgical procedure in pediatric surgical practice. It results in a dramatic improvement in patient survival and neurological function but is associated with several complications requiring multiple shunt revisions throughout a patient’s lifetime. The main aim of the study was to evaluate the outcome especially complications of shunt surgery at our center.
Methods: A single-institutional, retrospective observational study was conducted in 60 operated cases of congenital hydrocephalus with a minimum follow-up for up to 6 months. Parameters for analysis included demographic data, etiology of hydrocephalus, surgery time, and type of complications.
Results: Out of 86 patients, 60 patients who fulfilled the inclusion criteria were enrolled in the study. The mean age of the patients at the time of VP shunt placement was 3 months, range from 8 days to 15 years with male preponderance. The majority of the patients belonged to the 0-1-year age group (76.8%). The commonest etiology of hydrocephalus was congenital aqueduct stenosis. Fifteen patients (25%) developed complications within six months follow-up period. Eight patients (13.3%) developed clinical shunt infection with four cases having culture positive. Four (6.67%) had mechanical complications in the form of shunt obstruction. Three patients had ascites, subdural collection, and shunt extrusion from the anus. The shunt related mortality was 1.67%.
Conclusion: The shunt infection and obstruction still remain the most important complications. Despite inherent problems, shunt surgery is the procedure of choice until a safer effective alternative is available.
Keywords: Complications congenital hydrocephalus, ventriculoperitoneal shunt
Description
Suman Phuyal, Binod Rajbhandari, Amit B Pradhanang, Gopal Sedain, Sushil K Shilpakar, Mohan R Sharma
Department of Neurosurgery, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
Keywords
Complications congenital hydrocephalus, ventriculoperitoneal shunt