Lumboperitoneal shunt

Lumboperitoneal shunt is a cerebrospinal fluid shunt, that has the advantage of completely extracranial surgical management, minimizing intracranial complications. An LP shunt has been intentionally adopted for patients who require Cerebrospinal fluid shunt.

In a three-year study, treated by LPS, patients undergoing preoperative evaluation were included into study group and others without preoperative evaluation were included into control group. Perioperative conditions, including Kiefer score (KHS), symptomatic control rate (SCR), Evans index, complications, long-term shunt revision rate, and quality of life (QOL), were synchronously investigated.

93 eligible patients were included in the study (study group: 51, control group: 42). The baseline characteristics of two groups were basically similar. The results showed patients in study group had better short-term improvement in symptoms and imageology, including higher SCR (Median, 62.5% vs 50%, P=0.001), more reduction in Evans index (0.08±0.05 vs 0.05±0.04, P=0.002), and lower incidence of postoperative complications (Median, 35.3% vs 57.1%, P=0.04). Similarly, the incidence of shunt revision in study group was dramatically lower than control group (Median, 15.7% vs 40.9%, P=0.006) in line with the revision-free curve (P=0.002), in which suggested most of patients received revision, if needed, within 3 months. Additionally, patients in study group had better QOL.

In conclusion, patients who underwent the evaluation before LPS had better short-term and long-term outcomes, suggesting it would be a promising strategy to correctly select patients for LPS with prolonged favorable shunt outcomes 1).

Sun T, Yuan Y, Zhang Q, Zhou Y, Li X, Yu H, Tian M, Guan J. Establishing a preoperative evaluation system for lumboperitoneal shunt: Approach to attenuate the risk of shunt failure. World Neurosurg. 2018 Jun 12. pii: S1878-8750(18)31236-1. doi: 10.1016/j.wneu.2018.06.021. [Epub ahead of print] PubMed PMID: 29906581.
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