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General surgery involvement with ventriculoperitoneal shunt insertions reduces revision rates.

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Citation: Clinical Neurology & Neurosurgery. 199:106263, 2020 Oct 01.PMID: 33059316Institution: MedStar Washington Hospital CenterDepartment: Neurosurgery | Surgery/General SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020 ISSN:

0303-8467

Name of journal: Clinical neurology and neurosurgeryAbstract: BACKGROUND: Ventriculoperitoneal shunts (VPS) are placed for a variety of etiologies. It is common for general surgery to assist with insertion of the distal portion in the peritoneum.CONCLUSION: The use of general surgeons in VPS insertion can be of benefit by decreasing operative time, length of stay, total revisions, and distal revision rates. Further prospective studies are warranted to determine true benefit. Copyright (c) 2020 Elsevier B.V. All rights reserved.METHODS: A retrospective review of all consecutive patients undergoing VPS placements was performed in a three-year period (2017-2019). Those that underwent placement with general surgery were compared to those without general surgery. Additionally, patients undergoing distal placement via mini-laparotomy versus laparoscopy were compared. Multivariable logistic regression was used to examine risk factors for distal VPS failure.OBJECTIVE: To determine if there is a difference in revision rates in patients undergoing VPS placement with general surgery as well as those undergoing laparoscopic insertion.RESULTS: 331 patients were included. 202 (61.0 %) underwent VPS placement with general surgery. 121 (36.6 %) patients underwent insertion via laparoscopic technique. General surgery involvement reduced operative times, decreased length of stay, and lowered overall revision rates with distal revision rates being most significant (1.5 % vs 8.5 %; p=0.0034). Patients undergoing VPS placement via laparoscopic technique had decreased operative time, length of stay, in-hospital complications and revision rates, with significant decrease in shunt infection (1.7 % vs 7.1 %; p=0.0366). A history of prior shunt or abdominal surgery (OR 3.826; p=0.0282) and lack of general surgery involvement (OR 20.98; p=0.0314) are independent risk factors for distal shunt revision in our cohort.All authors: Anaizi AN, Briscoe J, Carroll AH, Dowlati E, Jackson PG, Nair MN, Patel N, Pivazyan G, Shahjouie S, Shashaty MFiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1016/j.clineuro.2020.106263

Date added to catalog: 2020-12-29

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33059316	Available		33059316

BACKGROUND: Ventriculoperitoneal shunts (VPS) are placed for a variety of etiologies. It is common for general surgery to assist with insertion of the distal portion in the peritoneum.

CONCLUSION: The use of general surgeons in VPS insertion can be of benefit by decreasing operative time, length of stay, total revisions, and distal revision rates. Further prospective studies are warranted to determine true benefit. Copyright (c) 2020 Elsevier B.V. All rights reserved.

METHODS: A retrospective review of all consecutive patients undergoing VPS placements was performed in a three-year period (2017-2019). Those that underwent placement with general surgery were compared to those without general surgery. Additionally, patients undergoing distal placement via mini-laparotomy versus laparoscopy were compared. Multivariable logistic regression was used to examine risk factors for distal VPS failure.

OBJECTIVE: To determine if there is a difference in revision rates in patients undergoing VPS placement with general surgery as well as those undergoing laparoscopic insertion.

RESULTS: 331 patients were included. 202 (61.0 %) underwent VPS placement with general surgery. 121 (36.6 %) patients underwent insertion via laparoscopic technique. General surgery involvement reduced operative times, decreased length of stay, and lowered overall revision rates with distal revision rates being most significant (1.5 % vs 8.5 %; p=0.0034). Patients undergoing VPS placement via laparoscopic technique had decreased operative time, length of stay, in-hospital complications and revision rates, with significant decrease in shunt infection (1.7 % vs 7.1 %; p=0.0366). A history of prior shunt or abdominal surgery (OR 3.826; p=0.0282) and lack of general surgery involvement (OR 20.98; p=0.0314) are independent risk factors for distal shunt revision in our cohort.

English