Late pediatric ventriculoperitoneal shunt failures: a Singapore tertiary institution's experience
| Autor: | Lester Lee, Colum P Nolan, Sharon Low, Lee Ping Ng, Wan Tew Seow, David C. Y. Low |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Age and sex Ventriculoperitoneal Shunt 030218 nuclear medicine & medical imaging Tertiary Care Centers Young Adult 03 medical and health sciences Ventriculoperitoneal shunts Postoperative Complications 0302 clinical medicine medicine Humans In patient Child Retrospective Studies Singapore business.industry Tertiary institution Retrospective cohort study General Medicine medicine.disease Surgery Hydrocephalus Equipment Failure Female Neurology (clinical) business 030217 neurology & neurosurgery Shunt (electrical) Follow-Up Studies |
| Zdroj: | Neurosurgical Focus. 41:E7 |
| ISSN: | 1092-0684 |
| Popis: | OBJECTIVE The introduction of ventriculoperitoneal shunts changed the way hydrocephalus was treated. Whereas much is known about the causes of shunt failure in the first few years, there is a paucity of data in the literature regarding the cause of late shunt failures. The authors conducted a study to find out the different causes of late shunt failures in their institution. METHODS A 10-year retrospective study of all the patients who were treated in the authors' hospital between 2006 and 2015 was conducted. Late shunt failures included those in patients who had to undergo shunt revision more than 5 years after their initial shunt insertion. The patient's notes and scans were reviewed to obtain the age and sex of the patient, the time it took for the shunt to fail, the reason for failure, and the patient's follow-up. RESULTS Forty-six patients in the authors' institution experienced 48 late shunt failures in the last 10 years. Their ages ranged from 7 to 26 years (12.23 ± 4.459 years [mean ± SD]). The time it took for the shunts to fail was between 6 and 24 years (mean 10.25 ± 3.77 years). Reasons for failure resulting in shunt revision include shunt fracture in 24 patients (50%), shunt blockage in 14 patients (29.2%), tract fibrosis in 6 patients (12.5%), shunt dislodgement in 2 patients (4.2%), and shunt erosion in 2 patients (4.2%). Postoperative follow-up for the patients ranged from 6 to 138 months (mean 45.15 ± 33.26 months). CONCLUSIONS Late shunt failure is caused by the effects of aging on the shunt, and the complications are different from early shunt failure. A large proportion are complications associated with shunt calcification. The authors advocate a long follow-up for pediatric patients with shunts in situ to monitor them for various causes of late shunt failure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|