Risk factors for ventriculoperitoneal shunting in children with posterior fossa tumor

Abstract EN

Objectives : to investigate the Predictors of the need of post-operative VP- shunting, in pediatric patients who underwent primary surgical resection for posterior fossa tumors, without pre-operative VP-shunt, were investigated.

Methods : all the 52 pediatric patients who presented to King Hussein Cancer Center in the last 12 years with a diagnosis of posterior fossa tumor, and who did not have a VP shunt inserted prior to undergoing their primary surgical resection in our institution, were included in the study.

Patients were divided retrospectively into those who ended up with VP-shunt insertion and those who did not need a VP-shunt insertion, and then factors such as age, sex, duration of pre-operative symptoms, size of primary tumor, presence of preoperative spinal metastasis, extent of surgical resection, post-operative ICP readings, presence of post-operative spinal metastasis and the development postoperative infection and leak were investigated and compared between the two groups.

Results : 24 patients needed a VP- shunt to be inserted in the post-operative period.

The extent of tumor excision and age below 3 years were the only significant predictors of post-operative need for VP-shunt insertion among the factors that were included in this study.

Conclusion: age of the patient less than 3 years was a significant factor in the need for shunt placement.The average age of the patients who needed a VP- shunt in our set of patients is 6.2 years compared to 7.3 years in patients who did not need a VP- shunt, The extent of tumor excision was also important factor in predicting the need for post-operative shunt insertion.

Other factors were not significant in this study even infection which increases the basal adhesion.