gms | German Medical Science

65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. - 14. Mai 2014, Dresden

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Inclusion of gravity assisted units in first time pediatric hydrocephalus shunts – Influence on shunt outcome

Meeting Abstract

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  • Marcel Kullmann - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland
  • Thayane Fritz - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland
  • Artemisia Dimostheni - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland
  • Karin Haas-Lude - Kinderkrankenhaus, Universitätsklinikum Tübingen
  • Martin U. Schuhmann - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.06.03

doi: 10.3205/14dgnc144, urn:nbn:de:0183-14dgnc1444

Veröffentlicht: 13. Mai 2014

© 2014 Kullmann 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

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Objective: The addition of a gravity-assisted unit (GAU) at the time of first shunt implantation in pediatric hydrocephalus is thought to prevent overdrainage right at the very beginning. However, the influence of GAUs on the shunt revision rate is unclear. We compared shunt survival data of two cohorts of children with first-time implanted adjustable shunts with and without GAU.

Method: Between 1/2006 and 08/2010 82 children underwent first-time shunt implantation. Starting in 2008 GAUs were added in increasing frequency. 31 children received Codman Medos programmable-valve (without GAU group A) and 33 Miethke proGAV valve (including GAU, group B). A retrospective data analysis was performed.

Results: Mean follow-up for group A was 40.7 months, for Group B 30.3 months. In Group A 18/31 (58%) underwent further shunt related surgery, in Group B 15/33 (45%). Valve related reasons for revision (overdrainage-underdrainage-valve occlusion) were found in 8-1-4 patients, respectively in Group A (72%) and 0-2-2 respectively in Group B (27%). Non-valve-dependent reasons for revision (catheter related-infection-wound healing problems) were found in 5-0-1 patients in Group A and 6-1-5 patients in Group B, respectively.

Conclusions: The addition of a GAU to an adjustable valve system at first-time shunt implantation does not seem increase the rate of shunt surgery during follow-up. In this study however, it significantly decreased the chance of overdrainage or other valve-related interventions.