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Updated: Aug 2, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ventriculopleural shunt outcomes for pediatric hydrocephalus: a single-institution experience
Daniel E Oyon1,2, Mandana Behbahani3, Shelly Sharma3
1Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. doyon@nm.org.
Insights
Ventriculopleural (VPL) shunts for pediatric hydrocephalus show high revision and pleural effusion rates. No patient factors predicted VPL shunt failure, indicating it
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Device Research
Background:
- Hydrocephalus is a common neurological condition in children requiring cerebrospinal fluid diversion.
- Ventriculoperitoneal (VP) shunts are the primary treatment, but complications can necessitate alternatives.
- Ventriculopleural (VPL) shunts offer an alternative diversion pathway, but their long-term efficacy and complication rates require evaluation.
Purpose of the Study:
- To analyze the failure and complication rates of ventriculopleural (VPL) shunts in pediatric hydrocephalus patients.
- To identify factors predicting early or late VPL shunt failure.
- To assess the viability of VPL shunts as a secondary treatment option.
Main Methods:
- Retrospective chart review of VPL shunt placements from 2000 to 2019.
- Data collection on patient demographics, shunt history, and shunt type.
- Kaplan-Meier survival analysis and statistical comparison of patient factors.
Main Results:
- Thirty-one pediatric patients underwent VPL shunt placement; 19 required revision, 7 due to pleural effusion.
- Overall shunt survival rates at 1, 3, 5, and 7 years were 76%, 62%, 55%, and 46%, respectively.
- No patient-specific factors, including shunt valve type, were significantly associated with shunt survival or complications.
Conclusions:
- VPL shunts are a viable second-line option for pediatric hydrocephalus when VP shunts are not feasible.
- High rates of shunt revision and pleural effusion are associated with VPL shunt use.
- Further research may be needed to optimize VPL shunt outcomes and patient selection.
Purpose:
The aim of this study is to analyze rates of ventriculopleural (VPL) shunt failure and complications among patients with pediatric hydrocephalus, and to analyze which factors may predict early (< 1 year) or late (> 1 year) VPL shunt failure in this sample.
Methods:
A retrospective chart review was conducted of all consecutive VPL shunt placements from 2000 to 2019 at our institution. Data was collected on patient characteristics, shunt history, and shunt type. Primary endpoints include rates of VPL shunt survival and rates of symptomatic pleural effusion. The Kaplan-Meier method was used to calculate shunt survival, and Fisher's exact test and t-test were used to compare differences between categorical variables and means, respectively (p < 0.05).
Results:
Thirty-one patients with pediatric hydrocephalus underwent VPL shunt placement (mean age 14.2 years). Of the 27 patients with long-term follow-up (mean 46 months), VPL shunt revision was required in 19, seven of which were due to pleural effusion. Overall shunt survival rates at 1, 3, 5, and 7 years were 76%, 62%, 55%, and 46%, respectively. Mean duration of shunt survival was 26.74 months. Overall pleural effusion rate was 26%. No patient-specific factors, including shunt valve type, were significantly associated with shunt survival, risk of early revision, or risk of pleural effusion.
Conclusions:
Our results are comparable to those reported in the literature and represent one of the largest case series on the topic. VPL shunts are a viable second-line option when ventriculoperitoneal (VP) shunt placement is not possible or desirable, though there are high rates of shunt revision and pleural effusion.
