Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution
Background/Objectives: This study aimed to investigate the surgical treatment and management of hydrocephalus in infants with meningomyelocele and compare the single-center experience with the previous studies. Methods: This retrospective study included 81 infants (47 females and 34 males) who under...
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2024-12-01
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| author | Çağlar Türk Umut Tan Sevgi Eda Karadağ Öncel Mahmut Çamlar Ozan Akgül Füsun Özer |
| author_facet | Çağlar Türk Umut Tan Sevgi Eda Karadağ Öncel Mahmut Çamlar Ozan Akgül Füsun Özer |
| author_sort | Çağlar Türk |
| collection | DOAJ |
| description | Background/Objectives: This study aimed to investigate the surgical treatment and management of hydrocephalus in infants with meningomyelocele and compare the single-center experience with the previous studies. Methods: This retrospective study included 81 infants (47 females and 34 males) who underwent meningomyelocele closure surgery and subsequent ventriculoperitoneal (VP) shunt surgery for hydrocephalus. Clinical and demographic data were retrospectively collected from hospital records, focusing on variables such as the timing of VP shunt placement relative to MMC closure, postoperative complications, and the need for shunt revisions. Patients were followed for a mean duration of 58.11 months to monitor long-term outcomes and identify factors associated with shunt failures and infections. Results: The mean follow-up period since birth was 58.11 (33.72) months. Shunt problems affected 30% (25/81) of patients with mechanical causes (8/25) and infections (6/25). A proximal mechanical malfunction/dysfunction was seen in 32% (8/25) of the shunts. Shunt infections occurred in 23% (19/81) of infants, and the mean time for shunt infection onset following the VP shunt procedure was 0 (0–39) median (min–max) months. Overall, 8 (9.9%) infants had short-term shunt infections, whereas 11 (13.6%) had long-term shunt infections. The mean length of the intensive care unit stay was 35.75 (25.28) days. Significant difference was seen in the number of shunt reoperations for short- and long-term infections (<i>p</i> < 0.001). All infants had at least one operation before the infection of their shunt system. Male gender was significantly associated with long-term shunt infections (<i>p</i> = 0.021). The study revealed methicillin-resistant coagulase-negative staphylococcus to be the most common isolated organism from infected shunts at 72.7% (6/11). Conclusions: This study demonstrates that hydrocephalic infants with meningomyelocele undergoing VP shunt surgery face notable risks of infection and mechanical complications, with methicillin-resistant coagulase-negative staphylococcus identified as the most common pathogen. The findings emphasize the importance of comprehensive postoperative care and targeted infection management to improve outcomes in this vulnerable population. |
| format | Article |
| id | doaj-art-4ef8e9d8ea3e4af8a49155cb9de5809f |
| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2024-12-01 |
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| series | Children |
| spelling | doaj-art-4ef8e9d8ea3e4af8a49155cb9de5809f2025-08-20T02:56:06ZengMDPI AGChildren2227-90672024-12-011112150810.3390/children11121508Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single InstitutionÇağlar Türk0Umut Tan Sevgi1Eda Karadağ Öncel2Mahmut Çamlar3Ozan Akgül4Füsun Özer5Department of Neurosurgery, Health Sciences University, Izmir City Hospital, 35540 Izmir, TurkeyDepartment of Neurosurgery, Health Sciences University, Izmir City Hospital, 35540 Izmir, TurkeyDepartment of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, 35220 Izmir, TurkeyDepartment of Neurosurgery, Health Sciences University, Izmir City Hospital, 35540 Izmir, TurkeyDepartment of Neurosurgery, Health Sciences University, Izmir City Hospital, 35540 Izmir, TurkeyDepartment of Neurosurgery, Health Sciences University, Izmir City Hospital, 35540 Izmir, TurkeyBackground/Objectives: This study aimed to investigate the surgical treatment and management of hydrocephalus in infants with meningomyelocele and compare the single-center experience with the previous studies. Methods: This retrospective study included 81 infants (47 females and 34 males) who underwent meningomyelocele closure surgery and subsequent ventriculoperitoneal (VP) shunt surgery for hydrocephalus. Clinical and demographic data were retrospectively collected from hospital records, focusing on variables such as the timing of VP shunt placement relative to MMC closure, postoperative complications, and the need for shunt revisions. Patients were followed for a mean duration of 58.11 months to monitor long-term outcomes and identify factors associated with shunt failures and infections. Results: The mean follow-up period since birth was 58.11 (33.72) months. Shunt problems affected 30% (25/81) of patients with mechanical causes (8/25) and infections (6/25). A proximal mechanical malfunction/dysfunction was seen in 32% (8/25) of the shunts. Shunt infections occurred in 23% (19/81) of infants, and the mean time for shunt infection onset following the VP shunt procedure was 0 (0–39) median (min–max) months. Overall, 8 (9.9%) infants had short-term shunt infections, whereas 11 (13.6%) had long-term shunt infections. The mean length of the intensive care unit stay was 35.75 (25.28) days. Significant difference was seen in the number of shunt reoperations for short- and long-term infections (<i>p</i> < 0.001). All infants had at least one operation before the infection of their shunt system. Male gender was significantly associated with long-term shunt infections (<i>p</i> = 0.021). The study revealed methicillin-resistant coagulase-negative staphylococcus to be the most common isolated organism from infected shunts at 72.7% (6/11). Conclusions: This study demonstrates that hydrocephalic infants with meningomyelocele undergoing VP shunt surgery face notable risks of infection and mechanical complications, with methicillin-resistant coagulase-negative staphylococcus identified as the most common pathogen. The findings emphasize the importance of comprehensive postoperative care and targeted infection management to improve outcomes in this vulnerable population.https://www.mdpi.com/2227-9067/11/12/1508external ventricular drainagehydrocephalusmeningomyeloceleshunt infection |
| spellingShingle | Çağlar Türk Umut Tan Sevgi Eda Karadağ Öncel Mahmut Çamlar Ozan Akgül Füsun Özer Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution Children external ventricular drainage hydrocephalus meningomyelocele shunt infection |
| title | Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution |
| title_full | Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution |
| title_fullStr | Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution |
| title_full_unstemmed | Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution |
| title_short | Clinical Outcomes and Complication Rates of Ventriculoperitoneal Shunts in Hydrocephalic Infants with Meningomyelocele: A Ten-Year Review at a Single Institution |
| title_sort | clinical outcomes and complication rates of ventriculoperitoneal shunts in hydrocephalic infants with meningomyelocele a ten year review at a single institution |
| topic | external ventricular drainage hydrocephalus meningomyelocele shunt infection |
| url | https://www.mdpi.com/2227-9067/11/12/1508 |
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