The Association between the Timing of Shunt Placement and Shunt Infection in Hydrocephalus Associated with Myelomeningocele

AIM: To determine whether the timing of shunt placement affects shunt infection rate in hydrocephalus associated withmyelomeningocele (MMC).MATERIAL and METHODS: The cases of 67 consecutive patients who underwent MMC repair and ventriculoperitoneal (VP)shunt placement between 2010 and 2017 were analyzed, retrospectively. Shunt infection rates were compared for three differentapproaches: simultaneous shunting (MMC repair and shunting in the same session; n=22), early shunting (shunting in the first weekafter MMC repair; n=21), and delayed shunting (shunting in the second week after MMC repair; n=24).RESULTS: Three patients in the simultaneous shunting group (13.6%) and two patients in the early shunting group (9.5%) developedshunt infection, whereas no such infections occurred in the delayed shunting group (p>0.05).CONCLUSION: While the shunt infection rates for the simultaneous, early and delayed shunting groups were not significant, it is ofinterest that no shunt infections occurred in the delayed shunting group. Investigation with a larger number of patients is warrantedto assess whether delayed shunting might reduce the risk of shunt infection.

Kaynakça

1. Arslan M, Eseoglu M, Gudu BO, Demir I, Kozan A, Gokalp A, Sosuncu E, Kiymaz N: Comparison of simultaneous shunting to delayed shunting in infants with myelomeningocele in terms of shunt infection rate. Turk Neurosurg 3:397-402, 2011

2. Bell WO, Arbit E, Fraser RA: One-stage myelomeningocele closure and ventriculoperitoneal shunt placement. Surg Neurol 27:233-236, 1987

3. Brau RH, Rodriguez R, Ramirez MV, Gonzales R, Martinez V: Experience in the management of myelomeningocele in Puerto Rico. J Neurosurg 72:726-731, 1990

4. Caldarelli M, Di Rocco C, La Marca F: Shunt complications in the first postoperative year in children with meningomyelocele. Child Nerv Syst 12:748-754, 1996

5. Chadduck WM, Reding DL: Experience with simultaneous ventriculo-peritoneal shunt placement and myelomeningocele repair. J Pediatr Surg 23:913-916, 1988

6. Chakraborty A, Crimmins D, Hayward R, Thompson D: Toward reducing shunt placement rates in patients with myelomeningocele. J Neurosurg Pediatr 5:361-365, 2008

7. Dupepe EB, Hopson B, Johnston JM, Rozzelle CJ, Jerry Oakes W, Blount JP, Rocque BG: Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele. Neurosurg Focus 5:E6, 2016

8. Ersahin Y, Mutluer S, Guzelbag E: Cerebrospinal fluid shunt infections. J Neurosurg Sci 38:161-165, 1994

9. Gamache FW Jr: Treatment of hydrocephalus in patients with meningomyelocele or encephalocele: A recent series. Childs Nerv Syst 11:487-488, 1995

10. Hubbalah MY, Hoffman HJ: Early repair of myelomeningocele and simultaneous insertion of ventriculoperitoneal shunt: Technique and results. Neurosurgery 20:21-23, 1987

11. Kulkarni AV, Drake JM, Lamberti-Pasculli M: Cerebrospinal fluid shunt infection: A prospective study of risk factors. J Neurosurg 94:195–201, 2001

12. Machado HR, Santos de Oliveira R: Simultaneous repair of myelomeningocele and shunt insertion. Childs Nerv Syst 2:107-109, 2004

13. Margaron FC, Poenaru D, Bransford R, Albright AL: Timing of ventriculoperitoneal shunt insertion following spina bifida closure in Kenya. Childs Nerv Syst 11:1523-1528, 2010

14. McLone DG, Dias MS: Complications of myelomeningocele closure. Pediatr Neurosurg 17:267-273, 1991

15. Miller PD, Pollack IF, Pang D, Albright AL: Comparison of simultaneous versus delayed ventriculoperitoneal shunt insertion in children undergoing myelomeningocele repair. J Child Neurol 11:370-372, 1996

16. Oktem IS, Menku A, Ozdemir A: When should ventriculoperitoneal shunt placement be performed in cases with myelomeningocele and hydrocephalus? Turk Neurosurg 4:387-391, 2008

17. Parent AD, McMillan T: Contemporaneous shunting with repair of myelomeningocele. Pediatr Neurosurg 22:132–136, 1995

18. Pople IK: Hydrocephalus and shunts: What the neurologist should know. J Neurol Neurosurg Psychiatry 73:17-22, 2002

19. Radmanesh F, Nejat F, Khashab ME, Ghodsi SM, Ardebili HE: Shunt complications in children with myelomeningocele: Effect of timing of shunt placement. J Neurosurg Pediatr 3:516-520, 2009

20. Tarcan T, Onol FF, Ilker Y, Alpay H, Simşek F, Ozek M: The timing of primary neurosurgical repair significantly affects neurogenic bladder prognosis in children with myelomeningocele. J Urol 176:1161-1165, 2006

21. Tuli S, Drake J, Lamberti-Pasculli M: Long term outcome of hydrocephalus management in myelomeningocele. Childs Nerv Syst 19:286-291, 2003

22. Tuli S, Drake J, Lawless J, Wigg M, Lamberti Pasculli M: Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg 92:31–38, 2000

23. Wakhlu A, Wakhlu G, Saxena S, Tandon RK: Single-stage treatment of spina bifida with hydrocephalus based on a prediction rule derived from preoperative cranial ultrasound. Pediatr Neurosurg 4:271-275, 2009

24. Xu H, Hu F, Hu H, Sun W, Jiao W, Li R, Lei T: Antibiotic prophylaxis for shunt surgery of children: A systematic review. Childs Nerv Syst 2:253-258, 2016

25. Yilmaz A, Musluman AM, Dalgic N, Cavusoglu H, Kanat A, Colak I, Aydin Y: Shunt insertion in newborns with myeloschisis/myelomenigocele and hydrocephalus. J Clin Neurosci 12:1493-1496, 2010

Kaynak Göster

Turkish Neurosurgery
  • ISSN: 1019-5149
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1989

4411

Sayıdaki Diğer Makaleler

Marking Basilar Artery Using Neuronavigation During Endoscopic Third Ventriculostomy: A Clinical Study

Onur ÖZGÜRAL, Gökmen KAHİLOĞULLARI, Giuseppe CINALLI, Umit EROGLU, İhsan DOĞAN, Eyyub S M AL BEYATI, Murat ZAİMOĞLU, Ağahan ÜNLÜ

Artificial Total Disc Replacement Versus Fusion for Lumbar Degenerative Disc Disease: An Update Systematic Review and Meta-Analysis

Yu Zhe LI, Piao SUN, Dong CHEN, Li TANG, Chun Hui CHEN, Ai-Min WU

Use of Muscle Graft versus Fascia Flap as Interpositional Material in Prevention of Reossification in a Rat Model of Skull Bone Defect

Ayhan OKUMUŞ, Erdem GÜVEN, İsmail ERMİŞ, Vakur OLGAÇ, Murat TOPALAN, Metin ERER

The Association between the Timing of Shunt Placement and Shunt Infection in Hydrocephalus Associated with Myelomeningocele

Mehmet Sabri GURBUZ, Mehmet Onur YUKSEL

Long-Term Outcomes of Pediatric Meningioma Surgery: Single Center Experience with 23 Patients

İlkay IŞIKAY, Sahin HANALIOGLU, Fırat NARİN, Ibrahim BASAR, Burçak BİLGİNER

Septum Pellucidum Cavernoma: A Case Report and Anatomical Consideration of an Extremely Rare Lesion

Aline Lariessy CAMPOS PAIVA, Renan Maximillian LOVATO, Jo o Luiz VITORINO ARAUJO, Jos Carlos ESTEVES VEIGA

Does Really Level of Transforaminal Epidural Steroid Injection Affect the Treatment Outcome?

Mehmet Cetin BASKAYA

Association of Two Primitive Carotid-Basilar Anastomoses and Cerebrovascular Abnormalities on the Brain Base: A Case Report

Milena TRANDAFILOVI, Ljiljana VASOVI, Slobodan VLAJKOVI, Marija DAKOVI BJELAKOVI

Successful Application of the Ventriculo-Gallbladder Shunt: A Salvage Procedure

Bülent GÜÇLÜ, Tufan HİÇDÖNMEZ, Utku ADİLAY, Yunus Emre ALTUNTAS