Abstract
A COMPARATIVE STUDY OF VALVE VERSUS NON-VALVE VENTRICULOPERITONEAL SHUNTS IN HYDROCEPHALUS

Avadhesh Kumar Bhardwaj* and Jalad Kapoor

ABSTRACT

Introduction: Variety of surgical techniques have been devised to affect extracranial shunting of cerebrospinal fluid in cases of hydrocephalus, the most common being ventriculoperitoneal, ventriculoatrial and lumboperitoneal shunts. Ventriculoperitoneal shunting is made either with the simple tubular device such as PVC tube (unishunts), or shunts with different types of valvular mechanism designed to control the flow of cerebrospinal fluid under varying circumstances. The protagonists of each type claim the advantages over the other. Ultimately however what matters would be the overall results obtainable by the two types. Aims and Objectives: Comparative evaluation of valve versus non-valve ventriculoperitoneal shunts in hydrocephalus cases. Material and methods: The present study was carried out on 45 patients suffering from hydrocephalus of different etiologies. All these cases were treated surgically by ventriculoperitoneal shunts. The shunt consisted of simple PVC tube (Ryle's tube or infant feeding tube) in 20 cases. A valvular shunt (Upadhyaya or Chhabra shunt) was employed in 25 cases. The efficacy and complications if any, were recorded and compared statistically in both the groups. The cases were followed for a period of 6-9 month. Results and Observations: 86.6% of subjects belonged to the first decade of life. A preponderance of male was observed in our study. 73.3% of cases comprised of congenital hydrocephalus. 10(22.2%) shunts developed obstructions during a period of followup. Infection was seen in 9(20%) out of 45 patients. Shunts were revised in 19(42.2%) out of 45 cases. Conclusions: Ventriculoperitoneal shunting of CSF is a safe and effective method of surgical treatment in all types of hydrocephalus. The success rate and frequency of complications is about the same in the two types of shunts i.e. unishunts and valvular shunts. However the unishunt is economical to the patient.

Keywords: Hydrocephalus, Ventriculoperitoneal shunts, Shunts.


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