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Ventriculo-peritoneal shunt requirement in children with posterior fossa tumours: an 11-year audit
V Kumar1, K Phipps, W Harkness
1Great Ormond Street Hospital for Children, London, UK.
Insights
In paediatric patients with posterior fossa tumours, age at diagnosis, tumour type, and surgical resection completeness significantly impact the need for shunt placement. Approximately 18.9% of children required post-operative shunts.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Clinical Outcomes Research
Background:
- Posterior fossa tumors are a significant cause of hydrocephalus in children.
- Management often involves cerebrospinal fluid (CSF) diversion, such as shunt placement.
- Predicting the need for shunting in pediatric posterior fossa tumor patients is crucial for optimizing care.
Purpose of the Study:
- To investigate the requirement for shunt procedures in pediatric patients with posterior fossa tumors.
- To identify factors influencing the need for post-operative shunt insertion in this patient cohort.
Main Methods:
- Retrospective review of 175 pediatric patients treated for posterior fossa tumors between 1983 and 1993.
- Analysis of patient age at diagnosis, tumor type, extent of surgical resection, and presence of CSF leak or infection.
- Evaluation of post-operative shunt placement rates and associated clinical variables.
Main Results:
- Shunt placement was required in 18.9% of the reviewed pediatric patients.
- Patient age at diagnosis was identified as a significant factor influencing shunt requirement.
- Tumor type and the completeness of tumor excision were also significant factors affecting the need for post-operative shunting.
Conclusions:
- Age, tumor type, and extent of surgical resection are critical determinants for post-operative shunt placement in pediatric posterior fossa tumors.
- These factors should be considered when planning surgical management and anticipating potential complications like hydrocephalus.
Abstract:
The authors reviewed 175 paediatric patients with posterior fossa tumours treated at the Hospital for Sick Children at Great Ormond Street, London, between 1983 and 1993, in an attempt to determine the requirement for shunt procedures in these children. The age of the patient population ranged from 4 months to 14 years 6 months. The factors evaluated included age at diagnosis, tumour type, extent of surgical resection, and the presence of CSF leak and/or infection. Shunt placement was required postoperatively in 18.9% of patients. Age of the patient was felt to be a significant factor in the need for shunt placement. Tumour type and completeness of tumour excision were also felt to be significant factors affecting the need for post-operative shunt insertion.