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Risk of failure in pediatric ventriculoperitoneal shunts placed after abdominal surgery
Joshua D Burks1, Andrew K Conner1, Robert G Briggs1
1Departments of 1 Neurosurgery and.
Journal of Neurosurgery. Pediatrics
|March 15, 2017
Summary
Pediatric shunt surgery shortly after abdominal surgery is linked to reduced shunt survival. Consider alternative shunt placements when feasible to improve outcomes for these patients.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Device Performance
Background:
- Clinical experience suggests a link between shunt malfunction and recent abdominal surgery.
- Limited literature explores the relationship between abdominal surgery and shunt survival.
Purpose of the Study:
- To investigate the association between abdominal surgery and ventriculoperitoneal shunt survival in pediatric patients.
- To compare shunt survival rates in patients with and without a history of abdominal surgery.
Main Methods:
- Retrospective review of pediatric ventriculoperitoneal shunt operations over a 7-year period.
- Comparison of shunt survival times between patients with prior abdominal surgery and a general pediatric cohort.
- Univariate and multivariate analyses to identify factors influencing shunt failure.
Main Results:
- 141 patients (468 shunt operations) were analyzed; 34 had prior abdominal surgery.
- Shunt surgery within 2 weeks of abdominal surgery showed an association with shunt failure (adjusted HR 3.6).
- Shunt surgery over 2 weeks after abdominal surgery was not significantly associated with shunt failure (p=0.86).
Conclusions:
- Performing shunt surgery soon after abdominal surgery correlates with decreased shunt survival.
- Alternative shunt termini may be beneficial for select patients to enhance shunt longevity.
