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01-12-2016 | Original Paper

Surgical outcome of the shunt: 15-year experience in a single institution

Authors: Sara Iglesias, Bienvenido Ros, Álvaro Martín, Antonio Carrasco, Miguel Segura, Andrea Delgado, Francisca Rius, Miguel Ángel Arráez

Published in: Child's Nervous System | Issue 12/2016

Abstract

Purpose

Surgical outcome after shunt insertion in pediatric hydrocephalus can vary greatly. Although first shunt survival rates and complications have been studied by several teams, much less is known about survival and complications of subsequent systems. The goals of this study were to evaluate the surgical outcome in a series of pediatric patients followed for a long time and establish the differences between first and subsequent extracranial shunt survival and complications.

Methods

We undertook a retrospective study in pediatric patients treated with ventriculoperitoneal shunts between 2000 and 2015 at our institution. Surgical outcome was assessed, and different shunt survival curves were studied with Kaplan-Meier. Complications related to each shunt failure were examined and compared.

Results

A total of 166 patients underwent 425 procedures, with a mean follow-up period of 93 months. The median number of shunt revision surgeries was 2. Shunt survival rates were better with the first shunt compared to those with the subsequent shunts. The main complication necessitating system revision surgery was overdrainage, the frequency of proximal and distal dysfunctions was similar in all the shunt failures, and isolated ventricle and infection were more frequent in younger patients. Shunt-related infections accounted for 7 % of the procedures, and the shunt independence rate was 10 %.

Conclusions

The frequency of complications related to shunt failure in pediatric patients changes during follow-up. A strict protocol of overdrainage detection and active treatment could explain the need for repeat surgeries and the progressively shorter shunt survival time in our series.

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Title: Surgical outcome of the shunt: 15-year experience in a single institution
Authors: Sara Iglesias
Bienvenido Ros
Álvaro Martín
Antonio Carrasco
Miguel Segura
Andrea Delgado
Francisca Rius
Miguel Ángel Arráez
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 12/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-016-3206-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical outcome of the shunt: 15-year experience in a single institution

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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