Replacement of Complicated VP Shunts with Endoscopic Third Ventriculostomy, Local Experience and Outcome | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 110, Volume 87, Issue 1, April 2022, Page 1653-1657 PDF (546.17 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2022.227711 | ||||
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| Authors | ||||
Karam Kenawy; Khalid Naser; Abdin K. Kasim 
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| Abstract | ||||
| Background: Until recent breakthroughs in neuroendoscopy, the ventriculoperitonal (VP) shunt remained the mainstay of hydrocephalus therapy. However, shunt complications, including obstruction, infection and overshunting are frequent. Getting out of the siege of VP shunt is the dream of those patients. Objective: This study aimed to present our experience in managing VP shunt complications by endoscopic third ventriculostomy (ETV) and shunt removal. Patients and Methods: We reviewed 18 consecutive patients during the period from January 2017 to December 2020 with different ventriculoperitonal shunt complications. The authors retrospectively evaluated the causes, preoperative symptoms, and postoperative results for those patients who underwent ETV and shunt removal for management of shunt complications. Results: There were 11 males and 7 females with mean age of 12.9 years old. The mean shunt duration was 8 years. Shunts were unilateral (15 cases) or bilateral (3 cases). Shunt complications included: shunt obstruction (9 cases), shunt infection (8 cases) and overshunting (1 case). ETV was done in all cases with septostomy in 7 cases. The mean follow up period was 15 months during which, 15 patients were shunt independent while three patients needed new shunts within the first postoperative month. While transient CSF leak occurred in 4 cases, there was no mortality in this series. Conclusion: Removing a VP shunt and replacing it with ETV with or without septostomy is a possible option in managing shunt complication. | ||||
| Keywords | ||||
| Hydrocephalus; ETV; Neuroendoscopy; VP Shunt complications | ||||
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