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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Is the concurrent installation of ventricular-peritoneal shunt and Ommaya reservoir in pediatric patients with posterior fossa tumor prone to infection?

Meeting Abstract

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  • Katharina Lischka - Neurochirurgische Klinik der Uniklinik Essen, Essen, Deutschland
  • Oliver M. Müller - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Daniela Pierscianek - Department of Neurosurgery, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Nicolai El Hindy - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.12.06

doi: 10.3205/17dgnc069, urn:nbn:de:0183-17dgnc0694

Published: June 9, 2017

© 2017 Lischka et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Posterior fossa tumor (PF) is the most common brain tumor in children. Postoperative tumor protocol requires the application of intrathecal (ith) chemotherapy in certain cases. The installation of an Ommaya reservoir (OR) facilitates repeated ith application of chemotherapy. As many children with PF develop persistent hydrocephalus, installation of a ventricular-peritoneal shunt (VPS) device is mandatory as well. Many investigations cope with infection of either the OR, or VPS, but nothing has ever been reported about infection rate of simultaneously installed OR and VPS and repeated injection of chemotherapy. The aim of our investigation was to reveal complications with special respect to infection in this special situation.

Methods: We retrospectively reviewed the data of all children operated for PF in our department from 2011 to 2016. Inclusion criteria were simultaneously installed OR and VPS and application of ith chemotherapy. Data was analyzed with respect to age, sex, tumor entity, applied ith chemotherapy, infection and complications. Descriptive statistic was used to reveal differences.

Results: A total of 16 children (5 girls, 11 boys) with a median age of 7 years (range 4 months- 15 years) were included in the study. Predominant tumor entity was medulloblastoma in 13 (81.3%), PNET in 2 (12.5%) and ependymoma in 1 (6.2%) patient. There were no perioperative complications. In one child there was a wound dehiscence. 2 of the 16 (12.5%) children developed infections, which made VPS revision mandatory. OR remained in both cases. In one child Acetinobacter genomospecies 3 was found, in the other child suffering from fever, only cell count in CSF was elevated without detection of any microorganisms. Prior to OR and VPS installment, 15 of 16 children were provided with external ventricular drainage. In all cases (16/16) methotrexate was applied ith; in one child additional Etoposid was administered.

Conclusion: Despite installation of two intraventricular devices, repeated application of ith chemotherapy, adjuvant therapy with radiation and i.v. chemotherapy, infection rate is comparable to VP shunt installation.