Risk factors analysis of ventriculoperitoneal shunt after supratentorial neoplasms surgery in children

Abstract

Objective To screen the risk factors for ventriculoperitoneal shunt (VPS) after tumor resection in children with supratentorial neoplasms due to new hydrocephalus or progression of existing hydrocephalus. Methods Total 199 children who underwent supratentorial neoplasms resection at Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, from January 2011 to January 2021 were included. Socio-demographic data, course of disease and imaging data, tumor resection- related indicators and hydrocephalus occurrence and progression were collected. The risk factors for the occurrence or progression of existing hydrocephalus after supratentorial neoplasms resection were analyzed by univariate and multivariate Logistic regression. Results Fifteen of 199 children (7.54%) with supratentorial tumors required VPS after surgery, of which 14 had new hydrocephalus or progression of existing hydrocephalus within 2 weeks after surgery. Logistic regression analysis showed the presence of preoperative coexisting hydrocephalus (OR = 14.756, 95%CI: 3.451-63.089; P = 0.000), tumor adjacent to the midline (OR = 5.466, 95%CI:1.409-21.203; P = 0.014), and large intraoperative bleeding (OR = 1.295, 95%CI: 1.016-1.650; P = 0.037) were risk factors for the need of VPS in children with supratentorial tumors. Conclusions Development or progression of hydrocephalus after tumor resection in children with supratentorial neoplasms occurs mostly within 2 weeks after surgery. Children with preoperative coexisting hydrocephalus, tumor adjacent to the midline, and large intraoperative bleeding should be alerted to development and acute progression of hydrocephalus after surgery.

Keywords

• supratentorial neoplasms
• hydrocephalus
• ventriculoperitoneal shunt
• risk factors
• logistic models
• child