Lumboperitoneal and Ventriculoperitoneal Shunt Surgery for Posthemorrhagic Communicating Hydrocephalus: A Comparison

World neurosurgery(2019)

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摘要
OBJECTIVE: This study aimed to compare the efficacy and complications of lumboperitoneal (LP) and ven-triculoperitoneal (VP) shunt surgeries in patients with posthemorrhagic communicating hydrocephalus. METHODS: Retrospective analysis of the records of patients who were admitted to the Shanghai Tenth People's Hospital Affiliated to Tongji University between February 2012 and January 2018 was performed. The efficacy of the LP and VP shunt surgeries and their associated complications were compared. The evaluation of the efficacy of these surgeries involved both clinical and radiologic aspects. The evaluated complications included hemorrhage, infection, excessive drainage, seizure disorder, shunt obstruction, and migration. Revision and mortality were regarded as the consequence of complications and were collected. RESULTS: One-hundred and fifty-eight (115 males and 43 females) patients were treated with VP or LP shunt (102 vs. 56, respectively) for posthemorrhagic communicating hydrocephalus. The percentage of patients with a Glasgow Coma Scale (GCS) score between 3.00 and 12.00 was 79.11%. There was no significant difference in the observed clinical (P = 0.097) or radiologic (P = 0.360) improvements between the LP and VP shunt groups. The total rate of complications (P = 0.009) and hemorrhage (P = 0.03) were lower in the LP shunt group than in the VP shunt group. CONCLUSIONS: In the treatment of moderate and severe coma patients with posthemorrhagic communicating hydrocephalus, LP shunt surgery is equally as effective as the VP shunt surgery and is associated with fewer complications.
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关键词
hydrocephalus,lumboperitoneal shunt,post-hemorrhagic communicating hydrocephalus,ventriculoperitoneal shunt
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