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Updated: May 31, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Correlation between ventriculoperitoneal shunts and inguinal hernias in children: an 8-year follow-up
Yu-Chun Chen1, Jau-Ching Wu, Laura Liu
1Institute for Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany.
Insights
Children receiving ventriculoperitoneal shunts (VPS) before age 5 face a significantly higher risk of inguinal hernias (IH). This increased risk is most pronounced within the first two years post-surgery, necessitating vigilant monitoring for IH.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Gastroenterology
Background:
- Ventriculoperitoneal shunts (VPS) are common neurosurgical interventions for hydrocephalus in children.
- Inguinal hernias (IH) are a frequent surgical condition in pediatric populations.
- The potential association between VPS placement and IH development requires investigation.
Purpose of the Study:
- To determine the correlation between VPS placement and the subsequent development of IH in children.
- To quantify the risk of IH in children who have undergone VPS surgery.
- To identify the temporal relationship between VPS and IH.
Main Methods:
- A nationwide cohort study included 1,537,843 children aged 0-5 years (1996-2000).
- Subjects were divided into a VPS group (n=675) and an age/gender-matched control group (n=6704).
- Kaplan-Meier and Cox regression analyses were used to assess IH development over an 8-year follow-up period.
Main Results:
- The 8-year cumulative incidence of IH repair surgery was significantly higher in the VPS group (13.3%) compared to the control group (4.1%).
- Children with VPS had a 3.62-fold increased likelihood of developing IH (adjusted hazard ratio: 6.63).
- IH surgery occurred, on average, 1.73 years earlier in the VPS group.
Conclusions:
- Pediatric patients receiving VPS before age 5 exhibit an elevated risk of developing IH.
- The highest risk for IH manifestation is observed within the first two years following VPS placement.
- Close monitoring for inguinal symptoms is crucial in children with VPS, especially during the initial postoperative period.
Objective:
The goal of this study was to investigate the correlation between ventriculoperitoneal shunts (VPSs) and inguinal hernias (IHs) in children.
Methods:
Study subjects were identified from a nationwide cohort of 1 537 843 children aged 0 to 5 years from 1996 to 2000. They were assigned to the VPS group (n=675), who received VPS, or a control group (n=6704) of age- and gender-matched children. Both groups (N=7379) were followed up for 8 years for IH. Kaplan-Meier and Cox regression analyses were performed.
Results:
After the 8-year follow-up, 353 of the 7379 study subjects (78 from the VPS group and 275 from the control group) underwent IH surgery. The 8-year cumulative incidence rate of IH-repair surgery was 13.3% in the VPS group, significantly higher than that in the control group (4.1%; P<.001). Children in the VPS group were more likely to develop IH than the control group (hazard ratio: 3.62; P<.001), even after adjusting for age, gender, and comorbidities (adjusted hazard ratio: 6.63; P<.001). The average time interval between VPS and IH surgery was 1.73 years earlier in the VPS group than those in the control group (1.29 vs 3.02 years; P<.001).
Conclusions:
Children who received a VPS when younger than 5 years were more likely to have IH; the highest risk was during the first 2 years after VPS surgery. A high index of suspicion for inguinal manifestations is recommended during their follow-up.
