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Risk factors for postoperative ventriculoperitoneal shunt requirement in pediatric patients with brain tumors

Zesheng Ying, Wei Yang, Nijia Zhang

    Journal of Neurosurgery. Pediatrics
    |March 8, 2024
    PubMed

    Insights

    Postoperative ventriculoperitoneal shunt (VPS) placement after pediatric brain tumor resection is linked to specific risk factors. Medulloblastoma, ventricle tumors, and postoperative hematoma/hygroma increase the likelihood of needing a VPS.

    Area of Science:

    • Pediatric neurosurgery
    • Neuro-oncology
    • Neurosurgical complications

    Background:

    • Hydrocephalus frequently complicates pediatric brain tumors and can persist after surgical resection.
    • Ventriculoperitoneal shunt (VPS) placement is a common intervention for persistent hydrocephalus.
    • Identifying risk factors for VPS placement is crucial for optimizing patient management.

    Purpose of the Study:

    • To investigate perioperative risk factors associated with the need for postoperative ventriculoperitoneal shunt (VPS) placement in children with brain tumors.
    • To identify specific tumor characteristics and post-surgical complications that predict VPS requirement.

    Main Methods:

    • Retrospective study of 265 children (0-18 years) with tumors near CSF pathways undergoing resection (Oct 2015-Sep 2021).
    • Outcome assessed: VPS placement within 6 months of tumor resection.
    • Analysis included demographic, imaging, clinical variables, and adjuvant therapies.

    Main Results:

    • 14.34% of patients required VPS post-resection; 49.81% had preoperative hydrocephalus.
    • Independent risk factors for VPS included medulloblastoma (OR 4.15), lateral/third ventricle tumors (OR 4.07), postoperative intraventricular hematoma (OR 3.36), and non-operated area subdural hygroma (OR 2.78).

    Conclusions:

    • Tumor location (lateral/third ventricle), histology (medulloblastoma), and postoperative complications (intraventricular hematoma, subdural hygroma) are significant predictors of needing a VPS after brain tumor resection.
    • These factors aid in anticipating and managing hydrocephalus in pediatric neuro-oncology patients.
    Abstract

    Keywords:
    cerebrospinal fluid diversionhydrocephaluspediatric brain tumor

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