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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

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Published on: October 14, 2022

Extended subcutaneous tunnelling technique for external ventricular drainage.

G K K Leung¹, K B Ng, B B T Taw

¹Division of Neurosurgery, Department of Surgery, Li Ka Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR, China. gilberto@hkucc.hku.hk

British Journal of Neurosurgery

|August 7, 2007

Summary

The extended subcutaneous tunnel technique for external ventricular drains (EVD) showed a 6.8% infection rate, comparable to standard methods. Intraventricular urokinase was a significant risk factor for EVD infection.

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Area of Science:

Neurosurgery
Infectious Diseases
Medical Devices

Background:

External ventricular drains (EVD) are crucial for managing cerebrospinal fluid but carry a risk of infection.
Strategies to reduce EVD-related infections are actively sought.
Extended subcutaneous tunneling for EVD has been described but lacks recent investigation.

Purpose of the Study:

To evaluate the infection rate associated with the extended subcutaneous tunnel (long EVD) technique.
To identify predisposing risk factors for infection in patients with long EVD.
To compare the infection rate of long EVD with conventional EVD methods.

Main Methods:

Retrospective review of 114 patients undergoing long EVD insertion (133 cases total).
Analysis of infection rates, duration of drainage, and complication types.
Statistical analysis to identify significant risk factors for infection.

Main Results:

An overall infection rate of 6.8% was observed in the long EVD group (7 infections in 103 cases without pre-existent infection).
Intraventricular instillation of urokinase was the only statistically significant risk factor identified.
Non-infective complications occurred in 12.8% of cases.

Conclusions:

The infection rate of the long EVD technique is comparable to conventional EVD methods.
The extended subcutaneous tunnel did not significantly alter the weekly infection risk.
The long EVD technique did not demonstrate a distinct advantage over standard tunneling in this single-center audit.