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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Shunt-assistants with fixed versus adjustable opening pressures: Comparison of clinical parameters in the course of the treatment of pediatric hydrocephalus

Meeting Abstract

  • Ines Hallmann - Pädiatrische Neurochirurgie, Universitätsmedizin Mainz, Germany
  • Christoph A. Tschan - Abteilung für Neurochirurgie, Krankenhaus Ludmillenstift, Meppen, Germany
  • Alexandra Huthmann - Abteilung für Neurochirurgie, Krankenhaus Ludmillenstift, Meppen, Germany
  • Wolfgang Wagner - Pädiatrische Neurochirurgie, Universitätsmedizin Mainz, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 060

doi: 10.3205/16dgnc435, urn:nbn:de:0183-16dgnc4351

Veröffentlicht: 8. Juni 2016

© 2016 Hallmann et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The overdrainage of shunts in the treatment of pediatric hydrocephalus is – in the long-term – one of the most frequent and most challenging complications. Since many years, anti-gravity valves are available to treat overdrainage. We studied retrospectively possible differences in the course of hydrocephalus treatment when using shunt-assistants with fixed opening pressures (SA; 10 - 35 cm H2O) versus shunt-assistants with postoperatively adjustable opening pressures (proSA; 0-40 cm H2O) (Miethke, Potsdam, Germany).

Method: The data of 46 children, aged 0-16 years and operated on in the Department of Pediatric Neurosurgery Mainz between 2003 and 2012, were evaluated. The studied parameters were the type of shunt-assistant (SA versus proSA), the time of recovery from complaints and the frequency of necessary secondary operations.

Results: In 27 children, a shunt-assitant with fixed opening pressure (SA) and in 19 patients, a shunt-assistant with postoperatively adjustable opening pressure (proSA, both devices Miethke, Potsdam, Germany) was implanted. From the 27 children with SA, 15 (55%) had to undergo a revision surgery (change of the valve) because of ongoing slit ventricle problems. In the 19 cases with proSA, the opening pressure had to be a adjusted in the postoperative period up to 9 times per patient (average of adjustements during the first year: 2.3 per patient), but no revision surgery was necessary. The mean time until recovery from complaints was 6 years in SA patients and 2 years in proSA patients.

Conclusions: The results confirm the a priori plausibility assumption that the frequency of necessary revision surgeries and the recovery time are markedly lower when using a postoperatively adjustable shunt-assistant. In particular the reduction of secondary surgeries overweighs the primarily higher costs of adjustable shunt assitants.