ANALYSIS OF THE TREATMENT RESULTS OF COMPLICATIONS OF VENTRICULOPERITONEAL SHUNTING SURGERY IN CHILDREN

The purpose of this study was to analyze the demographic data of children who had complications associated with ventriculoperitoneal shunt surgery and to review the clinical characteristics, surgical procedures performed to treat complications of ventriculoperitoneal shunt surgery and the final results. This is an observational study conducted in an institution that involved children under the age of 12 who required revision after ventriculoperitoneal shunt surgery during the study period. During the 10-year study period, 336 ventriculoperitoneal shunt catheters were implanted for the treatment of hydrocephalus in children. Forty (11.9 %) children developed various complications and required a revision of ventriculoperitoneal shunt surgery during the follow-up period. A total of 30 (8.9 %) children (21 boys and 9 girls) were selected to participate in this study, and they required 34 shunt revision procedures. The average interval between the introduction of the ventriculoperitoneal shunt and the diagnosis of the complication was 7.3 months. Complications of ventriculoperitoneal shunt surgery that required revision occurred in the following order of frequency: (1) Ventriculoperitoneal shunt catheter, cerebrospinal fluid, or shunt tract infection 8 (2.4 %); (2) malfunction of the distal catheter 7 (2.1 %); (3) distal catheter winding in the abdominal cavity 6 (1.8 %); (4) catheter extrusion 5 (1.5 %); (5) Liquorrhea from the wound area of the abdominal cavity/navel 4 (1.2 %); (6) malfunction of the ventricular catheter 3 (0.9 %); (7) cerebrospinal fluid pseudocyst in the abdominal cavity 1 (0.3 %). To treat the above complications, surgical procedures were performed in the following frequency order: (1) revision of the distal catheter of the shunt 14 (4.2 %); (2) removal of the entire catheter + external ventricular drainage 7 (2.1 %); (3) distal ventriculoperitoneal catheter converted to external ventricular drainage 6 (1.2 %); (4) revision of the proximal ventriculoperitoneal catheter 3 (0.9 %); (5) revision of the entire ventriculoperitoneal catheter 3 (0.9 %); (6) removal of cerebrospinal fluid pseudocyst 1 (0.3 %). This study also noted 2 (6.6 %) deaths in the postoperative period. The installation of a ventriculoperitoneal shunt performed for the treatment of hydrocephalus in infants and young children was accompanied by various complications. Seventy percent of complications occurred within the first 6 months after the installation of the ventriculoperitoneal shunt. Two thirds of the complications were related to the distal ventriculoperitoneal catheter.