Clinical Interventions in Aging (Mar 2023)
Clinical Outcome and Safety of Lumboperitoneal Shunt in the Treatment of Non-Obstructive Hydrocephalus
Abstract
Ning-Ping Foo,1,2 Yang Chien Tun,3 Che Chao Chang,4,5 Hung-Lin Lin,3 Cheng-Hsin Cheng,2,4,* Hao-Yu Chuang4,6,* 1Department of Emergency, An Nan Hospital, China Medical University, Tainan, 70965 Taiwan; 2Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, 71101 Taiwan; 3Department of Neurosurgery, China Medical University Hospital, Taichung, 40447 Taiwan; 4Department of Neurosurgery, An Nan Hospital, China Medical University, Tainan, 70965 Taiwan; 5Neurophysiology Laboratory, Department of Surgery, National Cheng Kung University Medical Center and Medical School, Tainan, 70101 Taiwan; 6Department of Neurosurgery, China Medical University Beigang Hospital, Beigang, Yunlin County, 65152 Taiwan*These authors contributed equally to this workCorrespondence: Cheng-Hsin Cheng; Hao-Yu Chuang, Department of Neurosurgery, An-Nan Hospital, China Medical University, No. 66, Sec. 2, Changhe Road, Annan District, Tainan City, Taiwan, Tel +886-6-3553111, Email [email protected]; [email protected]: This study aimed to evaluate the functional outcomes of lumboperitoneal (LP) shunt for the treatment of non-obstructive hydrocephalus.Methods: We retrospectively studied the clinical surgical results of 172 adult patients with hydrocephalus who underwent LP shunt surgery between June 2014 and June 2019. Data regarding the following were collected: pre- and postoperative symptom status, third ventricle width changes, Evans index, and postoperative complications. Additionally, the baseline and follow-up Glasgow Coma Scale (GCS) score, Glasgow Outcome Scale (GOS), and Modified Rankin Scale (mRS) scores were investigated. All patients were followed up for ≥ 12 months using clinical interview and braining imaging using computed tomography (CT) scan or magnetic resonance imaging (MRI).Results: Majority of patients presented with normal pressure hydrocephalus as the etiology of their disease (48.8%), followed by cardiovascular accident (28.5%), trauma (19.7%), and brain tumor (3%). The mean GCS, GOS, and mRS improved postoperatively. The average period from symptomatic onset to surgery was 402 days. The average width of the third ventricle on CT scan or MRI was 11.43 mm preoperatively and 10.8 mm postoperatively (P< 0.001). The Evans index improved from 0.258 to 0.222 after operation. The symptomatic improvement score was 7.0, with a complication rate of 7%.Conclusion: Significant improvement was observed in the functional score and brain image after LP shunt placement. Moreover, the satisfaction with symptomatic improvement after surgery remains high. LP shunt operation is a viable alternative in the treatment of non-obstructive hydrocephalus due to the low complication rate, fast recovery, and high satisfaction.Keywords: clinical outcome, complication, lumboperitoneal shunt, non-obstructive hydrocephalus
