Jehuda Soleman1, Haggai Benvenisti1, Shlomi Constantini1, Jonathan Roth2. 1. Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel. 2. Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel. jonaroth@gmail.com.
Abstract
PURPOSE: In this study, we investigate the occurrence rate of early shunt infection and malfunction in pediatric patients after converting an external ventricular drainage (EVD) to a ventriculo-peritoneal shunt (VPS) without replacing the ventricular catheter. METHODS: Data was retrospectively reviewed for 17 pediatric patients (11 male (64.7%), mean age 7.5 years, range 0.25-15 years) who underwent 18 consecutive direct conversions of tunneled EVD to VPS without replacing the ventricular catheter between 2008 and 2017. In each case, the EVD was inserted in sterile fashion within the operating room and tunneled subcutaneously 5-7 cm away from the insertion site. Primary outcome measure was the occurrence of early (within 30 days) VPS infection or malfunction. The mean follow-up time was 56.8 months (±35.7 months). RESULTS: The mean period of EVD before VPS placement was 9.0 days (±3.6 days, range 2-18 days). Five patients had shunt infections/malfunctions. One patient (5.6%) had an early shunt infection after 30 days. One patient had a late shunt infection after 9 months. One patient had an early shunt malfunction after 9 days. Two patients (11.1%) had late shunt malfunctions after 6.5 months and 9 years. There were no other incidents of shunt-related complications or shunt-related mortality. CONCLUSION: In the pediatric population, the conversion of a tunneled EVD to a VPS without replacing the ventricular catheter can be safely done. Cranial entry is spared, while the rates of shunt infection and malfunction do not increase significantly.
PURPOSE: In this study, we investigate the occurrence rate of early shunt infection and malfunction in pediatric patients after converting an external ventricular drainage (EVD) to a ventriculo-peritoneal shunt (VPS) without replacing the ventricular catheter. METHODS: Data was retrospectively reviewed for 17 pediatric patients (11 male (64.7%), mean age 7.5 years, range 0.25-15 years) who underwent 18 consecutive direct conversions of tunneled EVD to VPS without replacing the ventricular catheter between 2008 and 2017. In each case, the EVD was inserted in sterile fashion within the operating room and tunneled subcutaneously 5-7 cm away from the insertion site. Primary outcome measure was the occurrence of early (within 30 days) VPS infection or malfunction. The mean follow-up time was 56.8 months (±35.7 months). RESULTS: The mean period of EVD before VPS placement was 9.0 days (±3.6 days, range 2-18 days). Five patients had shunt infections/malfunctions. One patient (5.6%) had an early shunt infection after 30 days. One patient had a late shunt infection after 9 months. One patient had an early shunt malfunction after 9 days. Two patients (11.1%) had late shunt malfunctions after 6.5 months and 9 years. There were no other incidents of shunt-related complications or shunt-related mortality. CONCLUSION: In the pediatric population, the conversion of a tunneled EVD to a VPS without replacing the ventricular catheter can be safely done. Cranial entry is spared, while the rates of shunt infection and malfunction do not increase significantly.
Authors: Zafer Cinibulak; Alfred Aschoff; Anani Apedjinou; Jan Kaminsky; Hans A Trost; Joachim K Krauss Journal: Acta Neurochir (Wien) Date: 2016-03-01 Impact factor: 2.216
Authors: Athanasios A Konstantelias; Konstantinos Z Vardakas; Konstantinos A Polyzos; Giannoula S Tansarli; Matthew E Falagas Journal: J Neurosurg Date: 2015-03-13 Impact factor: 5.115