Comparison of simultaneous versus delayed ventriculoperitoneal shunt insertion in children undergoing myelomeningocele repair.

摘要: The timing of cerebrospinal fluid shunt insertion for those neonates with hydrocephalus in association myelomeningocele remains controversial. To examine whether there was a difference either the complication rate or mean hospital stay undergoing repair and shunting under same anesthetic (simultaneous group) versus whom delayed several days after closure (sequential group), we reviewed results obtained these two approaches series 69 consecutive patients who underwent both at our institution between 1987 1993. Twenty-one infants simultaneous shunting, 48 sequential procedures. decision to concurrently rather than fashion based primarily on surgeon preference initial head circumference, which did not differ significantly groups. frequency type hydrocephalus-related complications (e.g., wound leak, infection, malfunction) that occurred during first 6 months were compared Neither overall nor malfunction, symptomatic Chiari malformation differed In contrast, higher leak group (eight zero; P = .05). Mean also longer (22 13 days; These suggest ventriculoperitoneal reduces back morbidity evidence birth, without an inordinate increase shunt-related complications.