gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Rate of post-operative shunt-implantation after surgery for posterior fossa tumours in children

Anzahl der postoperativen Shuntimplantationen nach Operation eines Tumors der hinteren Schädelgrube bei Kindern

Meeting Abstract

Suche in Medline nach

  • corresponding author C. Goetz - Neurochirurgische Klinik der Universität München
  • M. Neusser - Neurochirurgische Klinik der Universität München
  • A. Peraud - Neurochirurgische Klinik der Universität München
  • E. Uhl - Neurochirurgische Klinik der Universität München

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-15.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0073.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Goetz et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Evaluation of eventual changes concerning the rate of shunt-implantations after surgery for posterior fossa tumours in children, who have been treated in our department between January 1990 und June 2002.

Methods

A department-based databank was searched for patients younger than 16 years with surgery for a posterior fossa tumour between January 1990 and June 2002. After reviewing the obtained data 94 patients (51 boys and 43 girls) remained for evaluation.

Results

The mean age was 6.8 years (10 months to 15 years). Mean follow-up was 6.4 years. Histology was as follows: 32 medulloblastomas, 33 pilocytic astrocytomas, astrocytoma WHO grade II (4) and grade III (8), ependymoma grade II (6) and grade III (1), and ‘other histologies’ (10). 18/94 patients needed permanent CSF-drainage (Group A). Their mean age was 5.2 (±3.6) years compared to 7.1 (±4.4) years in children without shunts (Group B). In 5 children a shunt-system was implanted before tumour-operation. Of the remaining 89 children 37 (42%) had external ventricular drainage in the peri-operative period (Group A 77%, Group B 36%). In Group B the mean CSF-drainage was 94 (±92) ml/day while it was 205 (±78) ml/day in group A (p=0.003). In group B external drainage remained in place for 2.7 (±1.9) days, in group A for 6.7 (±4.5) days (p=0.007). Preoperative papilledema or preoperative nausea/vomiting were no predictors for postoperative shunt-dependency, but shunt-dependent children stayed longer on the ICU (9.7 days vs. 3.1 days) after tumour surgery (p=0.005). Postoperative shunt-dependency was not related to histology, (15.6% of the medulloblastoma-patients vs. 12.1% of the patients with pilocytic astrocytoma). Time interval between tumour surgery and shunt implantation increased clearly from the beginning of the observation period (mean 10.8 days from 1990 to 1994 vs. mean 22.8 days from 1995 to 2002) while the incidence decreased (25.9% shunt-implantation 1990 to 1993, 16.1% 1994 to 1997 and 3.2% 1998 to 2002).

Conclusions

The rate of shunt implantation after posterior fossa surgery in children has decreased within the last decade in our department. Prolonged postoperative need for CSF-drainage may indicate shuntdependency. Histology had no impact on later shunt-implantation.