The long-term outcome of children with VP shunt and hydrocephalus: motor developmental outcome and QOL of patients with hydrocephalus is associated with the number of revisional procedures but is not impacted by the type of the valve.
Danielle S Wendling-Keim, Hannah Luz, Elena Kren, Oliver Muensterer, Markus Lehner
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引用次数: 0
Abstract
Purpose: Despite constant advances in ventriculo-peritoneal shunt systems, pediatric patients with hydrocephalus may present with neurodevelopmental delay. Therefore, we performed a study including a questionnaire, which aimed to analyze parameters that may have an impact on the cognitive function and quality of life of the pediatric patient with hydrocephalus.
Methods: In this retrospective study, we included 81 patients aged 0-17 with hydrocephalus who were treated with a ventriculo-peritoneal shunt at a single institution. Demographic data, etiology of the hydrocephalus, type of valve implanted, any revision procedures and any complications were analyzed and the neurodevelopmental outcome, epilepsy and quality of life were assessed using a questionnaire sent to these patients. Statistical analysis was performed using SPSS. The significance level was set at p ≤ 0.05.
Results: Questionnaires were sent to 81 patients who were treated at our institution over a mean retrospective study period of 18 years. Of these, 30 questionnaires were completed by the patients themselves or with the support of their families and included in the study. The etiology of the hydrocephalus as a non-controllable parameter did not affect the cognitive and motor development as well as the occurrence of epilepsy, cephalalgia and the quality of life. However, the number of revisions had a significant (p = 0.041) impact on the motor development of the child. The mean Wellbeing Five score was better with 19.63 in the group with no revisions whereas the score was 12.2 in the group with more than two revisional procedures. The type of the valve (adjustable or not adjustable) as a controllable parameter did not change any of the tested parameters (p > 0.05).
Conclusion: The number of revisional procedures significantly affected the motor development of pediatric patients with a ventriculo-peritoneal (VP) shunt calling for further research to improve VP shunt systems as well as surgical procedures like endoscopic third ventriculo-cisternostomy (ETV) in the future.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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