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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Combating complications following ventriculoperitoneal shunting in a new centre
Jude Kennedy C Emejulu1, Jideofor O Ugwu
1Neurosurgery Unit, Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. judekenny2003@yahoo.com
Insights
Ventriculoperitoneal shunting (VPS) is a common treatment for hydrocephalus, but complications like shunt infection occur frequently. Strict protocols and caregiver education can help minimize these risks in neurosurgical centers.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Device Complications
Background:
- Ventriculoperitoneal shunting (VPS) is the primary treatment for hydrocephalus across age groups.
- Despite its widespread use, VPS is associated with numerous complications.
- Evolving treatment strategies have not surpassed the prevalence of VPS.
Purpose of the Study:
- To prospectively evaluate the incidence of complications following VPS.
- To identify strategies for minimizing VPS-related complications.
- To establish a baseline for neurosurgical services in a developing region.
Main Methods:
- Prospective study of patients undergoing VPS between April 2006 and March 2008.
- Data collected via structured protocol, case notes, and clinical/theatre records.
- Study conducted in a neurosurgical center in south-east Nigeria.
Main Results:
- 49 patients diagnosed with hydrocephalus; 32 underwent VPS.
- A complication rate of 28% (9 patients) was observed post-VPS.
- Shunt infection was the most frequent complication, occurring in 9.3% of cases (3 patients).
Conclusions:
- VPS remains the definitive treatment for hydrocephalus in the study center.
- Shunt infection is the most common VPS complication, consistent with global findings.
- Implementing strict perioperative contamination prevention protocols and caregiver education is recommended to reduce complications.
Background:
Over the years, different approaches to the treatment of hydrocephalus have evolved across all age groups; however, ventriculoperitoneal shunting (VPS) remains the most widely used procedure, albeit with many complications.
Aims:
The aim of our study is to prospectively look at the incidence of complications following VPS in our centre, and to suggest ways of minimizing these complications.
Patients And Methods:
Between April 2006 and March 2008, all patients who had VPS in our centre were recruited for the study using a structured protocol from the time of admission to the time of discharge; data were augmented with case notes along with clinic and theatre records. Our centre is located in south-east Nigeria, and we commenced neurosurgical services in April 2006.
Results:
Within this 2-year period, 49 patients were definitively diagnosed with hydrocephalus and 32 underwent VPS, following which 9 (28%) had various complications - with shunt infection being the most common (n = 3; 9.3%).
Conclusion:
VPS is the definitive treatment modality for hydrocephalus in our centre, and shunt infection (as reported by several other authors) is the most common complication we encounter. Adopting a strict protocol for the prevention of perioperative contamination, as well as educating caregivers, is advocated to reduce this complication in any new neurosurgical centre.
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