A Study of Surgical Outcomes and Complications in Children Undergoing Ventriculoperitoneal Shunt in a Tertiary Care Hospital of Eastern India.

Abstract

Context: Hydrocephalus, which is characterized by an abnormal elevation of cerebrospinal fluid within the ventricles of the brain, is one of the more formidable neurosurgical challenges, particularly in pediatric patients. Ventriculoperitoneal (VP) shunt is the preferred procedure; however, it is often associated with high rates of complication, including obstruction, infection, and overdrainage. The present study evaluated the outcomes and complications from VP-shunting in a tertiary hospital in eastern India.

Aim: This study aims to evaluate the surgical outcomes and complications of VP shunting in pediatric patients of hydrocephalus and to determine risk factors associated with complications.

Settings and design: A prospective observational study carried out from October 2022 to June 2024 at a tertiary care center in eastern India.

Materials and methods: All pediatric patients diagnosed with hydrocephalus aged below 20 years were enrolled. The data were collected with the standard pro forma. All the procedures were performed under globally accepted protocols. Postoperative monitoring included routine computed tomography scan and shunt functioning assessment. The patients were followed up 3 and 6 months after the surgery to assess outcomes and complications.

Statistical analysis: The data were analyzed using SPSS version 22. Descriptive statistics summarized the demographic and clinical information. The Chi-square test, independent t-tests, and Kaplan-Meier survival analysis were performed to study associations of variables, comparison of variables, and analysis of the trend of shunt survival. Statistical significance was fixed at P < 0.05.

Results: The majority of patients were infants aged below 1 year (43.3%), with a male-to-female ratio of 3:2. The most common presenting symptom was an increase in head circumference (68.3%). The most common complication was shunt obstruction (11.7%); all others tied for second place, with infection and overdrainage occurring at 5% each. Clinically, 60% of patients improved at 3 months; however, this figure dropped to 53.3% by 6 months. Follow-up problems arose with 28.3% of the patients lost to follow-up at 6 months.

Conclusions: VP shunting is an effective intervention for pediatric hydrocephalus, with a high rate of early postoperative improvement. However, complications such as obstruction, infection, and overdrainage remain significant concerns. The findings highlight the need for improved surgical techniques, rigorous postoperative care, and strategies to enhance long-term follow-up in resource-limited settings.