Contemporaneous shunting with repair of myelomeningocele.

The combination of overt hydrocephalus and an open myelomeningocele in a newborn has prompted some authors to advocate the repair of the myelomeningocele and the performance of a shunt procedure during the same anesthetic procedure. Advocates of this approach stress the merits of administering only one anesthetic, diminution in incidence of cerebrospinal fluid leaks from the repair, and shortened hospital stay and the resultant cost-effectiveness. This study was performed to assess the complication rate of shunts inserted at the time of myelomeningocele repair as well as of those inserted at a later date as a separate procedure. It would later appear that the insertion of a ventriculoperitoneal shunt, contemporaneous with the repair of the myelomeningocele, does not increase the risks of shunt infection or shunt malfunction within the 1st year of life.