Lumboperitoneal shunt [Neurosurgery Wiki]

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====== 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]].
====Types====
[[Horizontal-Vertical Lumbar Valve System]]

[[Lumboperitoneal shunt with the Codman Hakim programmable valve]]

[[Strata NSC Lumboperitoneal Adjustable Pressure Shunt]]

[[Miethke Lumboperitoneal DualSwitch Valve Shunt]]

Conventional Silastic Lumboperitoneal Valve-less Shunt

===== Indications =====

[[Lumboperitoneal shunt indications]].


===== Technique =====

[[Lumboperitoneal shunt technique]].



====Complications====
see [[Lumboperitoneal shunt complication]].

==== Case series ====

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
((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.
)).