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Updated: Jul 27, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Paediatric ventriculoperitoneal shunt failures: 12-year experience from a Singapore children's hospital
Jia Xu Lim1, Hui Ping Han1, Yi Wen Foo1
1Neurosurgical Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Insights
Pediatric cerebrospinal fluid shunt failures are concerning. Recent central nervous system infection significantly increases the risk of 30-day ventriculoperitoneal shunt failure in children.
Area of Science:
- Pediatric Neurosurgery
- Hydrocephalus Management
- Medical Device Reliability
Background:
- Cerebrospinal fluid (CSF) shunt failures in children lead to significant morbidity.
- Ventriculoperitoneal shunts (VPS) are commonly used to treat pediatric hydrocephalus.
- Identifying factors predicting shunt failure is crucial for improving patient outcomes.
Purpose of the Study:
- To review institutional data on ventriculoperitoneal shunt (VPS) insertions in children.
- To identify factors associated with VPS failure in pediatric patients.
- To analyze the incidence and causes of early shunt failure.
Main Methods:
- Retrospective single-institution study over 12 years.
- Inclusion of all pediatric patients (<18 years) with VPS insertion.
- Statistical analysis of patient characteristics, hydrocephalus etiology, shunt details, and outcomes.
Main Results:
- 214 pediatric VPS patients analyzed; mean age 6 months, follow-up 44 months.
- Obstructive hydrocephalus (66.4%) and tumor-related etiology (30.8%) were most common.
- 30-day shunt failure rate was 9.3% (infections 4.2%, occlusions 3.3%). Recent CNS infection was a significant predictor (OR 15.4, p=0.028).
Conclusions:
- First large-scale study on pediatric shunt failure in Singapore.
- Recent central nervous system infection is a significant risk factor for 30-day VPS failure.
- Cerebrospinal fluid constituent values did not correlate with shunt failure in this cohort.
Purpose:
Cerebrospinal fluid (CSF) shunt failures in children are devastating. The primary aims of this study are to, firstly, review our institutional series of ventriculoperitoneal shunt (VPS) insertions and identify factors associated with shunt failure.
Methods:
This is a single-institution, retrospective study conducted over a 12-year period. All patients under 18 years old with VPS inserted were included. Variables of interest such as patient characteristics, hydrocephalus aetiology, shunt implant details, and outcomes were subjected to statistical analyses.
Results:
A total of 214 VPS patients were selected for this study. The mean age at VPS insertion was 6 months with a mean follow-up duration of 44 months. The most common type of hydrocephalus was obstructive (n = 142, 66.4%), and the most frequent aetiology was tumour-related (n = 66, 30.8%). The 30-day shunt failure rate was 9.3%: 9 infections (4.2%), 7 occlusions (3.3%), and 4 others (1.9%). After multivariable analysis, only recent central nervous system (CNS) infection prior to VPS insertion remained significant (OR 15.4 (1.3-175), p = 0.028).
Conclusion:
This is the first, large-scale local study focused on the shunt failure in Singaporean children. Significant findings in our study demonstrate that recently treated CNS infection is a factor associated with 30-day shunt failure while the values of CSF constituents were not contributory.
