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Updated: May 21, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Factors influencing the perception of shunt devices in children after ventriculo-peritoneal shunts
Lijun Wan1, Kuo Zeng1, Zhongyin Guo1
1Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Insights
Children with hydrocephalus aged seven and older, or those with post-shunt complications, are more likely to perceive their subcutaneous shunt devices. Awareness and open communication are key for managing associated anxieties in pediatric patients.
Area of Science:
- Pediatric Neurosurgery
- Child Psychology
- Medical Device Perception
Background:
- Hydrocephalus significantly impacts children's emotional, cognitive, and social well-being, often overlooked in clinical outcomes.
- Subjective perception of medical devices like shunts is a critical, yet understudied, aspect of pediatric care.
Purpose of the Study:
- To identify factors influencing the subjective perception of subcutaneous shunt devices in pediatric hydrocephalus patients.
- To understand the lived experience of children with ventriculo-peritoneal shunts (VPS).
Main Methods:
- Retrospective analysis of 86 pediatric patients who underwent VPS.
- Data collection via telephone follow-up, including demographics, shunt details, complications, and subjective device perception.
Main Results:
- 73% of patients perceived their subcutaneous shunt devices, with common locations including the neck, behind the ear, and chest.
- Independent risk factors for device perception were age at follow-up (≥7 years) and post-shunt complications (OR=3.860, P=0.02; OR=4.956, P=0.02).
Conclusions:
- Pediatric hydrocephalus patients aged seven or older, or those with post-shunt complications, report a higher subjective perception of their subcutaneous shunt devices.
- Parents should be informed about this perception to provide attentive care and clear explanations, mitigating potential anxieties.
Objective:
The impact of hydrocephalus on the emotional, cognitive, and social health of children is frequently overlooked when measuring clinical outcomes in children with hydrocephalus. The aim of this study was to determine factors that influence the subjective perception of the subcutaneous shunt devices in children with hydrocephalus after ventriculo-peritoneal shunts (VPS).
Methods:
A retrospective analysis was performed on a cohort of 86 pediatric patients who underwent VPS at the Department of Neurosurgery, Tongji Hospital, between January 2012 and July 2022. Clinical information such as gender, age at surgery, age at follow-up, post-shunt complications, postoperative shunt replacements or shunt revisions, adjustments for valve opening pressure(VOP), brands of shunt devices, family situation, and the patients' subjective perception of the subcutaneous shunt devices were collected by telephone follow-up.
Results:
Of the 86 children, 63 (73%) perceived the existence of the subcutaneous shunt devices (32% at the level behind the ear, 16% at the chest, 52% at the neck), among which 3 children were particularly sensitive and more anxious. The independent risk factors for the subjective perception of shunt devices were age at follow-up (≥ 7 years) and post-shunt complications with odds ratios of 3.860 (P = 0.02) and 4.956 (P = 0.02) respectively.
Conclusion:
In pediatric hydrocephalic patients who have undergone VPS, those aged seven years or older or who experienced post-shunt complications may exhibit a significant subjective perception of subcutaneous shunt devices. It is crucial for parents to be cognizant of this potentiality, and offer attentive care and thorough explanations to relieve any associated anxieties.
