Adem KURTULUŞ, Ayhan TEKİNER, Halil KUL, Yavuz ERDEM, Haydar ÇELİK, Mehmet Emre YILDIRIM, Mehmet Akif BAYAR

Pediatrik Hidrosefali Olgularında Şant Revizyonlarının Değerlendirilmesi

Giriş: Ventriküloperitoneal şant uygulaması hidrosefalili hastalarda en sık kullanılan yöntemlerden biridir. Bu çalışmanın amacı şant cerrahisi sonrası gelişen komplikasyon ve revizyon nedenlerini ortaya koymak ve bu durumlara karşı alınabilecek önlemleri tartışmaktır.Yöntemler: 2000 - 2016 yılları arasında hidrosefali nedeniyle ventriküloperitoneal şant cerrahisi uygulanan pediatrik yaş grubundaki 248 hastanın retrospektif olarak şant revizyonları incelenmiştir.Bulgular: Opere edilen 248 hastanın 127 tanesi (%51,2) kız, 121 tanesi (%48,8) erkekti. Ortalama yaş 12 ay bulundu. En sık görülen etyolojik neden konjenital hidrosefaliydi. 248 hastanın 71 tanesine (%28,6) revizyon cerrahisi uygulandı. Revizyon cerrahisi yapılan 71 hastanın 23 tanesine (%32,4) birden fazla sayıda revizyon cerrahisi uygulandı. Revizyon cerrahisinin kendi içinde oranlarına baktığımızda enfeksiyon (%21,7) ve ventriküler kateter tıkanıklığı (%17,1) en sık nedenler idi.Sonuç: Pediatrik hastalarda ventriküloperitoneal şant cerrahisine bağlı revizyon cerrahisi oranları, tanı ve tedavi yöntemlerinin gelişmesine ve hakkında bir çok araştırma yapılmasına rağmen halen yüksek seyretmektedir. Revizyon cerrahisinin önlenebilir nedenlerinin araştırılıp incelenmesi yüksek olan revizyon oranlarını düşürmeye yardımcı olabilir.

Anahtar Kelimeler:

Hidrosefali, Komplikasyon, Meningomyelosel, Ventriküloperitoneal Şant

Evaluation of Shunt Revisions in Pediatric Hydrocephalus Cases

Introduction: Ventriculoperitoneal shunt surgery is one of the most commonly used methods in patients with hydrocephalus. This study aims to reveal the causes of complications and revision after shunt surgery and discuss measures that can be taken against these situations.Methods: We retrospectively reviewed the shunt revisions of 248 pediatric age groups who underwent ventriculoperitoneal shunt surgery due to hydrocephalus between 2000 and 2016. Results: Of the 248 patients, 127 (51.2%) were female and 121 (48.8%) were male. The mean age was 12 months. The most common etiologic cause was congenital hydrocephalus. 71 of 248 patients (28.6%) underwent revision surgery. More than one revision surgery was performed in 23 (% 32.4) of 71 patients who underwent revision surgery. Infection (21.7%) and ventricular catheter occlusion (17.1%) were the most frequent causes of revision surgery.Conclusion: The rate of revision surgery due to ventriculoperitoneal shunt surgery in pediatric patients is still high despite the development of diagnosis and treatment methods and many researches about it. Investigating preventable causes of revision surgeons may help to reduce high revision rates.

Keywords:

Hydrocephalus, Complications, Meningomyelocele, Ventriculoperitoneal Shunt,

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