The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland · 2025
Ventriculo-pleural shunt --- A second line option in the management of complex hydrocephalus.
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Li Hanqiao, Caird John
Аннотация
BACKGROUND: Ventriculo-pleural (V-Pl) shunt is considered as an alternative management of hydrocephalus when previous management options of hydrocephalus, including ventriculoperitoneal (VP) shunt, ventriculo-atrial (VA) shunt and endoscopic third ventriculostomy (ETV), may be contraindicated or have failed.
AIM: The aim is to identify the indications of V-Pl shunt after the failure of first-line managements of hydrocephalus, to evaluate the efficacy of V-Pl shunt with regarding to other shunt options and to discuss the potential complications.
METHODS: 15 patients who underwent V-Pl shunt (or V-Pl shunt related surgeries) from 2021 to 2024, are recorded retrospectively. The data was collected via patients' medical charts and national image archiving system (Republic of Ireland). Related literature and case reports were searched via keyword selections on research databases, including Pubmed and Google Scholar.
RESULTS: The indications for shunt treatment were spina bifida, tumour related hydrocephalus, congenital hydrocephalus, arachnoid cysts and idiopathic intracranial hypertension. Indications for favouring V-Pl shunt over VP/VA shunt or ETV are multiple shunt failures, persistent shunt-related symptoms, severe kyphoscoliosis, abdominal ascites/pseudocyst, jugular vein thrombosis. Complications of V-Pl shunt include shunt failure, over-drainage, pleuritic chest pain, pneumothorax and rarely slit-ventricle syndrome.
CONCLUSION: V-Pl shunt can be considered as a second line management for hydrocephalus when VP/VA shunt and ETV options have been exhausted.
AIM: The aim is to identify the indications of V-Pl shunt after the failure of first-line managements of hydrocephalus, to evaluate the efficacy of V-Pl shunt with regarding to other shunt options and to discuss the potential complications.
METHODS: 15 patients who underwent V-Pl shunt (or V-Pl shunt related surgeries) from 2021 to 2024, are recorded retrospectively. The data was collected via patients' medical charts and national image archiving system (Republic of Ireland). Related literature and case reports were searched via keyword selections on research databases, including Pubmed and Google Scholar.
RESULTS: The indications for shunt treatment were spina bifida, tumour related hydrocephalus, congenital hydrocephalus, arachnoid cysts and idiopathic intracranial hypertension. Indications for favouring V-Pl shunt over VP/VA shunt or ETV are multiple shunt failures, persistent shunt-related symptoms, severe kyphoscoliosis, abdominal ascites/pseudocyst, jugular vein thrombosis. Complications of V-Pl shunt include shunt failure, over-drainage, pleuritic chest pain, pneumothorax and rarely slit-ventricle syndrome.
CONCLUSION: V-Pl shunt can be considered as a second line management for hydrocephalus when VP/VA shunt and ETV options have been exhausted.