Endoscopic Lavage for the Treatment of Multiple Shunt Failures in Children.

AIM: To compare the efficacy of neuroendoscopic lavage (NEL) and shunt revision (SR) in the treatment of multiple shunt failures in children with hydrocephalus.

MATERIAL AND METHODS: The data of 56 pediatric patients who underwent surgeries for the treatment of shunt failure were retrospectively reviewed. Patients were divided into 2 groups as simple SR (Group A) and NEL+SR (Group B). Demographic characteristics, co-morbidities, surgical interventions, cerebrospinal fluid (CSF) analyzes, and complications were recorded and statistically compared for both groups.

RESULTS: Among the 56 patients, 51 of them presented with shunt dysfunction due to infectious debris or clots at different times. 28 of 51 patients (54.9%) were female and 23 (45%) were male. The mean age was 7.3 months. Simple SR was performed in 30 cases (Group A), and NEL and simultaneous SR were performed in 21 patients (Group B). The risk of shunt dysfunction was significantly lower in Group B (p 0.05).The risk of infection was high in Group A, but this was not statistically significant (p 0.05).

CONCLUSION: Simultaneously endoscopic lavage and shunt revision is an effective method in the treatment of shunt dysfunction in children. It is also superior to simple shunt revision for the risk of shunt dysfunction. More clinical studies are needed to verify this outcome.