Simultaneous repair of myelomeningocele and shunt insertion

Machado, Hélio Rubens; Oliveira, Ricardo Santos de

doi:10.1007/s00381-003-0853-7

Cited by 41 publications

(42 citation statements)

References 19 publications

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“…Epstein et al (7) and Radmanesh et al (20) indicated that V-P shunt placement can be performed concurrently with MM repair without causing more complications than in separate application. Some authors (4,10,12,15,20) have indicated that simultaneous MM repair and shunt insertion in infants with overt HCP at birth is a safe method and does not increase risk of shunt complication, decreases risk of further brain damage and decreases risk of wound breakdown and CSF leakage; Machado and DeOlivera (12) concluded in their study on 24 patients with HCP that simultaneous shunt placement and MM repair does not pose more risk than delayed shunt placement.…”

Section: Resultsmentioning

confidence: 99%

“…Timing of shunt insertion in infants with MM and HCP has been debated. Many authors have suggested the repair of MM and shunt insertion during same session (4,10,12,20). According to them, in patients with HCP and MM, insertion of shunt in same session would provide a swift recovery of back, avoid a second operation, protect the brain from deterious effects of progressive HCP resulting from delayed shunting and decrease duration of hospitalization (7,10,15,20,23).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of simultaneous shunting to delayed shunting in infants with myelomeningocele in terms of shunt infection rate

Arslan¹,

Eşeoğlu²,

Güdü³

et al. 2011

Turkish Neurosurgery

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AIm: Timing of shunt insertion in infants with myelomeningocele (MM) and hydrocephalus (HCP) has been debated. Many authors have suggested to perform the repair of MM and shunt insertion during same operation. However, there is also an opposite view. mAterIAl and methOds:We analyzed retrospectively 166 patients who underwent MM Sac repair to evaluate whether there are difference between these two methods in terms of shunt infection rate. results:In the same session, V-P (ventriculoperitoneal) shunt placement was performed onto 65 infants within the first 48 hours of postnatal and 36 infants were operated 48 hours after birth. In separate sessions, repair of MM were performed onto 29 infants within the first 48 hours of postnatal and shunting was peformed 7 days after sac repair. 14 infants were performed MM sac repair 48 hours after birth, then shunt was applied 7 days after closure of MM. Shunt infection rate in concurrently operated groups was markedly high (12.3 % in early surgery, 33.3% in late surgery); in separatedly operated groups' shunt infection rate was lower (3.44% in early surgery, 14.29% in late surgery). COnClusIOn:We propose to perform V-P shunt placement and MM repair in separate sessions. BulGulAr: Yaşamın ilk 48 saat içinde 65 infanta aynı seansda şant yerleştirilmesi ve myelomeningosel tamiri yapıldı ve doğumdan 48 saat sonra (3 ile 7 gün arasında) 36 infanta yine aynı seansda şant yerleştirilmesi ve kese tamiri yapıldı. Ayrıca yaşamın ilk 48 saat içinde 29 infanta myelomeningosel tamiri yapıldı ve ortalama 7 gün sonra ayrı bir seansda şant takıldı. 14 infanta myelomeningosel tamiri yapıldı doğumdan 48 saat sonra (doğumdan sonra 3 ile 7 gün arasında) ve kese tamirinde 7 gün sonra şant takıldı. Şant infeksiyon oranı aynı anda ameliyat edilen grupta belirgin olarak yüksekti (erken cerrahi yapılan grupta: %12.3, Geç cerrahi yapılan grupta: %33.3). Ayrı seanslarda ameliyat edilen grupta şant infeksiyon oranı düşüktü (erken cerrahi yapılan grupta: %3.44, geç cerrahi yapılan grupta: %14.29).sOnuÇ: Sonuç olarak biz ayrı seanslarda myelomeningosel kese tamiri ve şant yerleştirilmesini öneriyoruz.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of simultaneous shunting to delayed shunting in infants with myelomeningocele in terms of shunt infection rate

Arslan¹,

Eşeoğlu²,

Güdü³

et al. 2011

Turkish Neurosurgery

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“…The complication of infection is frequently faced in myelomeningocele cases, particularly in those requiring shunting for hydrocephalus, where infection significantly affects the mortality and morbidity 1,2,4 . For this reason, 228-231 Diagnosis of central nervous system infection by CSF sampling of the myelomeningocele sac as an alternative to ventricular tap diagnosis of CNS infection in these cases is more significant.…”

Section: Discussionmentioning

confidence: 99%

“…The other complication that can accompany these cases is hydrocephalus, a condition that often requires shunt treatment [1][2][3] . This situation increases the importance of the follow-up of myelomeningocele cases in search of the risk of infection 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of central nervous system infection by CSF sampling of the myelomeningocele sac as an alternative to ventricular tap

et al. 2010

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SummaryBackground. Infection significantly affects mortality and morbidity in myelomeningocele cases. Ventricular tap is the most common method performed to diagnose central nervous system (CNS) infection in myelomeningocele patients. However, the ventricular tap can cause serious trauma to the baby and to the family. Here we discuss the technique of taking a cerebrospinal fluid (CSF) sample from the sac in myelomeningocele cases.Methods. The study comprised 24 myelomeningocele patients undergoing sac repair; 7 patients in the early period and 17 in the late period (after the first 24 hours). CSF samples were taken from the sac and via ventricular tap. In all patients' samples, cell count and cultures were compared.Results. In patients who underwent early meningomyelocele repair there was no significant difference between sac and ventricular CSF. There were also no positive cultures in samples taken from both areas. In comparison, in the group submitted to late repair, the number of cells in the sac and ventricle CSF samples was over 10 in 4 of the 17 patients. The cultures from CSF samples taken from both areas were positive for E. coli. In 13 of 17 patients who were admitted to our clinic for late repair, there was no significant difference between the number of cells in the sac and in ventricular samples. Cultures taken from these patients were negative.Conclusion. Puncture of the sac represents a quicker and more convenient way to obtain CSF in myelomeningocele cases. In addition, there was no increase in pain to a level that would cause stress for the baby. A CSF sample can be taken from the sac for diagnosis of CNS infection in myelomeningocele patients. This method, therefore, represents a safer and more comfor-

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“…Şant ameliyatının uzun sürmesi, hastanın yaşı (özellikle prematürelerde), hastanın ameliyat sırasında başka enfeksiyonunun bulunması, deri bütünlüğünün olmaması durumunda enfeksiyon riski artar. Bunun yanında beyin cerrahisi ekibinin tecrübeli olması ve profilaktik antibiyotik kullanıldığında enfeksiyon riski azalır (3,5,(10)(11)(12)(13)(14). Sunulan olguda gelişen P. aeruginosa'ya bağlı ventrikü-lite zemin hazırlayan herhangi bir faktör yoktu.…”

Section: Discussionunclassified

Pseudomonas aeruginosa'ya bağlı ventrikülitli bir olgu A case with ventriculitis due to Pseudomanas Aeruginasa

Tanıl;ÇİFÇİ¹

2005

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Ventriküloperitoneal şant, hidrosefalisi olan hastaların intrakranial basıncını azaltmak amacıyla sıklıkla kullanılır. Şant enfeksiyonları ventriküloperitoneal şantı olan hastaların %7-9'unda görülür ve mortalite oranı %10-13'tür. En sık etken koagülaz-negatif stafilokoklardır. Ventrikülit ise ventriküllerin enfeksiyonu olup, şant enfeksiyonlarının en ciddi, morbidite ve mortalitesi en yüksek komplikasyonudur. Burada meningosel ve hidrosefali nedeniyle ventriküloperitoneal şant konulan bir hastada gelişen Pseudomonas aeruginosa'nın neden olduğu ventrikülit olgusu sunulmaktadır. Anahtar sözcükler: ventrikülit, Pseudomonas aeruginosa, ventriküloperitoneal şantVentriculoperitoneal shunt is frequently used to decrease intracranial pressure in patients with hydrocephaly. Shunt infections are seen in 7-9% of patients with ventriculoperitoneal shunt, and the mortality rate is 10-13%. The most common agent is coagulase-negative Staphylococcus in these patients. Ventriculitis, infection of ventricules, is the most severe, and being have the highest morbidity and mortality in complications of shunt infections. Here, a case with ventriculoperitoneal shunt for meningocele and hydrocephaly who has Pseudomonas aeruginosa ventriculitis is presented.

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Simultaneous repair of myelomeningocele and shunt insertion

Cited by 41 publications

References 19 publications

Comparison of simultaneous shunting to delayed shunting in infants with myelomeningocele in terms of shunt infection rate

Comparison of simultaneous shunting to delayed shunting in infants with myelomeningocele in terms of shunt infection rate

Diagnosis of central nervous system infection by CSF sampling of the myelomeningocele sac as an alternative to ventricular tap

Pseudomonas aeruginosa'ya bağlı ventrikülitli bir olgu A case with ventriculitis due to Pseudomanas Aeruginasa

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