Turkish Neurosurgery 2022 , Vol 32 , Num 2
Safety Analysis of Simultaneous Cranioplasty and Ventriculoperitoneal Shunt Placement
Xiangtong ZHANG1,Xiaofeng FANG1,Aili GAO2,Dong GUAN3,Chunmei GUO1,Sen WANG1,Yongan CHEN1,Boxian ZHAO1,Kongbin YANG1,Enxi HU1,Hongsheng LIANG1,Fulan HU4
1The First Affiliated Hospital of Harbin Medical University, Department of Neurosurgery, Harbin, P. R. China
2School of Life Science, Northeast Agricultural University, Harbin, P. R. China
3Qingdao Hospital of Traditional Chinese Medicine, Department of Neurosurgery, P. R. China
4Shenzhen University Health Science Center, School of Public Health, Department of Biostatistics and Epidemiology, Shenzhen, China
DOI : 10.5137/1019-5149.JTN.30740-20.2 AIM: To investigate the safety of combined cranioplasty (CP) and ventriculoperitoneal shunt (VPS) placement. Furthermore, we investigated whether the sequence of these procedures affects the postoperative complication rates associated with staged CP and VPS placement.

MATERIAL and METHODS: We retrospectively investigated patients who developed communicating hydrocephalus after decompressive craniectomy and subsequently underwent VPS placement and CP at the hospital at which this study was performed between January 2009 and December 2019. Patients were categorized into group 1 (simultaneous CP and VPS placement) and group 2 (CP and VPS placement performed separately). Group 2 was subcategorized into subgroup 2a (CP performed before VPS placement) and subgroup 2b (VPS placement performed before CP). The Student?s t and Chi square tests were used to analyze intergroup differences.

RESULTS: This study included 86 patients; 22 in group 1 and 64 in group 2 (24 patients in subgroup 2a and 40 patients in subgroup 2b). No statistically significant difference was observed in the overall complication rates between groups 1 and 2 (36.4% vs. 28.1%, P=0.591). However, the incidence of infections was significantly higher in group 1 than in group 2 (22.7% vs. 4.7%, P=0.024). Subgroup analysis showed that the overall complication rate was signi?cantly lower in subgroup 2a than in subgroup 2b (12.5% vs. 37.5%, P=0.031).

CONCLUSION: Simultaneous CP and VPS placement is associated with a high incidence of infections. Moreover, compared with initial CP, initial VPS placement is associated with a significantly higher risk of overall complications in patients who undergo a staged procedure. Keywords : Decompressive craniectomy, Cranioplasty, Ventriculoperitoneal shunt, Complication

Corresponding author : Hongsheng LIANG, lianghongsheng11@163.com