Effect of ventricular catheter entry point and tip location on Proximal End occlusion: A Multicenter Study in Pediatric Patients
Öz
This multicenter study investigates the relationship between entry site and shunt tip position in proximal VP shunt dysfunctions. The medical records of 51 pediatric patients who were hospitalized for shunt dysfunction between 2010 and 2021 were retrospectively reviewed at Bursa Uludağ University, Ankara University, and Selçuk University. The study did not find a statistically significant relationship between the entry site of the shunt and the location of the shunt tip in terms of proximal shunt occlusion. However, it is believed that factors such as the choroid plexus and ependymal reaction play a more significant role in proximal shunt occlusion. Our findings are consistent with previous studies and emphasize the importance of the choroid plexus and ependymal reaction in shunt dysfunction. The study did not observe significant associations between the entry site of the shunt, etiology of shunt dysfunction, location of the proximal end on CT scans, and the risk of shunt failure. However, the study has limitations, including its retrospective design and limited sample size. Future prospective studies with larger sample sizes are needed. This study provides a foundation for future research aimed at improving the long-term effectiveness of VP shunt treatment and reducing complications in pediatric patients.
Anahtar Kelimeler
Proximal shunt dysfunctions ventricular shunting entry site Hydrocephalus
Kaynakça
- 1. Bondurant CP, Jimenez DF. Epidemiology of cerebrospinal fluid shunting. Pediatric neurosurgery. 1995;23(5):254-9.
- 2. Khan F, Rehman A, Shamim MS, Bari ME. Factors affecting ventriculoperitoneal shunt survival in adult patients. Surgical neurology international. 2015;6.
- 3. Wu Y, Green NL, Wrensch MR, Zhao S, Gupta N. Ventriculoperitoneal shunt complications in California: 1990 to 2000. Neurosurgery. 2007;61(3):557-63.
- 4. Stein SC, Guo W. Have we made progress in preventing shunt failure? A critical analysis. Journal of Neurosurgery: Pediatrics. 2008;1(1):40-7.
- 5. Reddy GK, Bollam P, Caldito G. Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World neurosurgery. 2014;81(2):404-10.
- 6. Paff M, Alexandru-Abrams D, Muhonen M, Loudon W. Ventriculoperitoneal shunt complications: a review. Interdisciplinary Neurosurgery. 2018;13:66-70.
- 7. Mcclinton D, Carraccio C, Englander R. Predictors of ventriculoperitoneal shunt pathology. The Pediatric infectious disease journal. 2001;20(6):593-7.
- 8. McGirt MJ, Buck DW, Sciubba D, Woodworth GF, Carson B, Weingart J, et al. Adjustable vs set-pressure valves decrease the risk of proximal shunt obstruction in the treatment of pediatric hydrocephalus. Child's Nervous System. 2007;23:289-95.
- 9. Kehler U, Langer N, Gliemroth J, Meier U, Lemcke J, Sprung C, et al. Reduction of shunt obstructions by using a peel-away sheath technique? A multicenter prospective randomized trial. Clinical neurology and neurosurgery. 2012;114(4):381-4.
- 10. Dickerman R, McConathy W, Morgan J, Stevens Q, Jolley J, Schneider S, et al. Failure rate of frontal versus parietal approaches for proximal catheter placement in ventriculoperitoneal shunts: revisited. Journal of clinical neuroscience. 2005;12(7):781-3.
- 11. Farahmand D, Hilmarsson H, Högfeldt M, Tisell M. Perioperative risk factors for short term shunt revisions in adult hydrocephalus patients. Journal of Neurology, Neurosurgery & Psychiatry. 2009;80(11):1248-53.
- 12. Jeremiah KJ, Cherry CL, Wan KR, Toy JA, Wolfe R, Danks RA. Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure. Journal of Clinical Neuroscience. 2016;27:95-8.
- 13. Sampath R, Wadhwa R, Tawfik T, Nanda A, Guthikonda B. Stereotactic placement of ventricular catheters: does it affect proximal malfunction rates? Stereotactic and functional neurosurgery. 2012;90(2):97-103.
Proksimal Şant Disfonksiyonlarında Giriş Noktası ve Şant Ucu Konumu Arasındaki İlişkinin Araştırılması: Pediatrik Hastalarda Yapılan Çok Merkezli Bir Çalışma
Öz
Bu pediatrik birçok merkezli çalışma, proksimal şant disfonksiyonlarının giriş noktası ve şant ucu konumu arasındaki ilişkiyi incelemektedir. 2010 ile 2021 yılları arasında Bursa Uludağ Üniversitesi, Ankara Üniversitesi ve Selçuk Üniversitesi'nde şant disfonksiyonu nedeniyle hastaneye yatırılan 51 pediatrik hastanın tıbbi kayıtları geriye dönük olarak incelendi. Çalışmada, şantın giriş noktası ve şant ucunun konumuyla proksimal şant tıkanıklığı arasında istatistiksel olarak anlamlı bir ilişki saptanmadı. Bununla birlikte, koroid pleksus ve ependimal reaksiyon gibi faktörlerin proksimal şant tıkanıklığında daha önemli bir rol oynadığı düşünülmektedir. Bulgularımız, önceki çalışmaların bulgularıyla uyumludur ve şant disfonksiyonunda koroid pleksusun ve ependimal reaksiyonun önemini vurgulamaktadır. Çalışmamızda şantın giriş noktası, şant disfonksiyonunun etiyolojisi, proksimal uç yerleşimi ve şant başarısızlık riski arasında anlamlı ilişkiler gözlenmedi. Bununla birlikte, çalışmanın retrospektif tasarımı ve sınırlı örnekleme büyüklüğü gibi kısıtlamaları bulunmaktadır. Gelecekte daha büyük örneklemlerle prospektif çalışmalara ihtiyaç vardır. Bu çalışma, pediatrik hastalarda VP şant tedavisinin uzun vadeli etkinliğini artırmak ve komplikasyonları azaltmak için ileride yapılacak araştırmalar için bir temel oluşturmaktadır.
Anahtar Kelimeler
proksimal şant disfonksiyonu ventriküler şant giriş noktası hidrosefali
Kaynakça
- 1. Bondurant CP, Jimenez DF. Epidemiology of cerebrospinal fluid shunting. Pediatric neurosurgery. 1995;23(5):254-9.
- 2. Khan F, Rehman A, Shamim MS, Bari ME. Factors affecting ventriculoperitoneal shunt survival in adult patients. Surgical neurology international. 2015;6.
- 3. Wu Y, Green NL, Wrensch MR, Zhao S, Gupta N. Ventriculoperitoneal shunt complications in California: 1990 to 2000. Neurosurgery. 2007;61(3):557-63.
- 4. Stein SC, Guo W. Have we made progress in preventing shunt failure? A critical analysis. Journal of Neurosurgery: Pediatrics. 2008;1(1):40-7.
- 5. Reddy GK, Bollam P, Caldito G. Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World neurosurgery. 2014;81(2):404-10.
- 6. Paff M, Alexandru-Abrams D, Muhonen M, Loudon W. Ventriculoperitoneal shunt complications: a review. Interdisciplinary Neurosurgery. 2018;13:66-70.
- 7. Mcclinton D, Carraccio C, Englander R. Predictors of ventriculoperitoneal shunt pathology. The Pediatric infectious disease journal. 2001;20(6):593-7.
- 8. McGirt MJ, Buck DW, Sciubba D, Woodworth GF, Carson B, Weingart J, et al. Adjustable vs set-pressure valves decrease the risk of proximal shunt obstruction in the treatment of pediatric hydrocephalus. Child's Nervous System. 2007;23:289-95.
- 9. Kehler U, Langer N, Gliemroth J, Meier U, Lemcke J, Sprung C, et al. Reduction of shunt obstructions by using a peel-away sheath technique? A multicenter prospective randomized trial. Clinical neurology and neurosurgery. 2012;114(4):381-4.
- 10. Dickerman R, McConathy W, Morgan J, Stevens Q, Jolley J, Schneider S, et al. Failure rate of frontal versus parietal approaches for proximal catheter placement in ventriculoperitoneal shunts: revisited. Journal of clinical neuroscience. 2005;12(7):781-3.
- 11. Farahmand D, Hilmarsson H, Högfeldt M, Tisell M. Perioperative risk factors for short term shunt revisions in adult hydrocephalus patients. Journal of Neurology, Neurosurgery & Psychiatry. 2009;80(11):1248-53.
- 12. Jeremiah KJ, Cherry CL, Wan KR, Toy JA, Wolfe R, Danks RA. Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure. Journal of Clinical Neuroscience. 2016;27:95-8.
- 13. Sampath R, Wadhwa R, Tawfik T, Nanda A, Guthikonda B. Stereotactic placement of ventricular catheters: does it affect proximal malfunction rates? Stereotactic and functional neurosurgery. 2012;90(2):97-103.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi (Diğer) |
| Bölüm | Orjinal Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Ekim 2023 |
| Kabul Tarihi | 8 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 11 Sayı: 3 |
