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Ventriculoperitoneal shunt infections after bladder surgery: is mechanical bowel preparation necessary?
Kelly J Casperson1, Carolyn M Fronczak, Georgette Siparsky
1Children's Hospital, University of Colorado School of Medicine, Aurora, Colorado 80045, USA.
Insights
Mechanical bowel preparation before bladder reconstruction with bowel did not reduce infection rates in children with ventriculoperitoneal shunts. Bowel preparation appears unnecessary for these patients, simplifying surgical care.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Urology
Background:
- Ventriculoperitoneal shunts are common in children.
- Bladder reconstruction using bowel carries infection risks.
- The necessity of bowel preparation in these patients is unclear.
Purpose of the Study:
- To determine if mechanical bowel preparation reduces infection rates in children with ventriculoperitoneal shunts undergoing bladder reconstruction with bowel.
Main Methods:
- Retrospective chart review of 31 patients (2003-2009).
- Comparison of shunt infection incidence between patients who did and did not undergo bowel preparation.
- Fisher's exact test used for statistical analysis.
Main Results:
- 19 patients (61%) underwent bowel preparation, 12 (39%) did not.
- Overall infection rate was 9.6% (3/31).
- No significant difference in infection rates between groups (p=1.0).
Conclusions:
- Preoperative bowel preparation did not significantly impact shunt infection rates.
- Results suggest bowel preparation may be unnecessary for these patients.
- Simplifying surgical protocols can benefit patient care.
Purpose:
We investigated whether children with a ventriculoperitoneal shunt who undergo mechanical bowel preparation before bladder reconstruction with bowel have a lower rate of infection than children who do not undergo preoperative bowel preparation.
Materials And Methods:
We performed an institutional review board approved, retrospective chart review of the incidence of ventriculoperitoneal shunt infections after bladder reconstruction using bowel and compared infection rates using Fisher's exact test. Mean ± SD followup was 2.9 ± 2.3 years.
Results:
Between 2003 and 2009, 31 patients with a ventriculoperitoneal shunt underwent bladder reconstruction using bowel, of whom 19 (61%) and 12 (39%) did and did not undergo mechanical bowel preparation, respectively. There was no significant difference in gender or age at surgery between the 2 groups. Infection developed in 3 children (9.6%) within 2 months postoperatively, including 2 (10.5%) with and 1 (8.3%) without bowel preparation (2-tailed p = 1.0).
Conclusions:
There was no significant difference in the shunt infection rate between patients with a ventriculoperitoneal shunt who did and did not undergo preoperative bowel preparation. Our results add to the current literature suggesting that bowel preparation is unnecessary even in patients with a ventriculoperitoneal shunt.
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