The efficacy of 90cm-long peritoneal shunt catheters in newborns and infants.

Abstract

Ventriculoperitoneal (VP) shunt is one of the options for the treatment of hydrocephalus. The aim of this study is to describe the efficacy and safety of a 90cm-long peritoneal catheter in newborns and infants treated for hydrocephalus. We analyzed the incidence of distal-related complications and the need of successive surgeries for malfunction or for lengthening of the peritoneal catheter. We reviewed medical records of neonates and infants treated with a VP shunt using a 90cm-long peritoneal catheter. Function and integrity of shunts were assessed through abdominal echographic studies, skull, neck, chest and abdomen X-rays. We compared shunt revision rates due to distal complications and insufficient length of the peritoneal catheter in the study group with an historical control group composed by newborns and infants treated with a standard VP shunt at our Institution during the last twenty years. Three neonates and 3 infants were treated with the insertion of the 90cm-long distal catheter into the peritoneal cavity for its total length. The mean follow-up was 7.6 years. As compared to controls, in the study group the revision rate for distal complications was not significantly increased (P=0.33), whereas revision surgeries due to insufficient peritoneal catheter length were significantly reduced (P=0.04). This study demonstrates for the first time that the use of 90cm-long peritoneal catheters in neonates and infants is a safe and effective procedure. It does not increase the incidence of abdominal complications, avoiding the need of revision for insufficient length of the peritoneal catheter.