PTH-38 Indwelling peritoneal catheter service for malignant related ascites

Good abdominal wall closure is one of the basic surgical skills and is a common feature of almost all modernday CSF shunt operations. The fact that some patients require multiple abdominal operations highlights the need for a simple and effective technique for peritoneal catheter insertion through the abdominal wall and abdominal wall closure. Although technically simple, abdominal wall closure becomes more complex when combined with the requirement to maintain CSF shunt function in cases in which the shunt catheter passes through the abdominal wall into the peritoneal cavity. In this report, the authors describe a simple technique for passing the peritoneal catheter of a ventriculoperitoneal shunt through the abdominal wall on a pathway separate from the fascial opening. This technique minimizes the risk of abdominal wall–related complications and is especially important in high-risk patients such as those with obesity and/or diabetes and in children.

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Anal Extrusion of Ventriculoperitoneal Shunt: A Case Report and Review of Literature

Jurnal Kedokteran Brawijaya ◽

10.21776/ub.jkb.2021.031.04.13 ◽

2021 ◽

Vol 31 (4) ◽

pp. 13

Author(s):

Farhad Bal'afif ◽

Donny Wisny Wardhana ◽

Tommy Alfandy Nazwar ◽

Novia Ayuning Nastiti

Keyword(s):

Physical Examination ◽

Ventriculoperitoneal Shunt ◽

Surgical Procedure ◽

Rare Complication ◽

Female Child ◽

Contributing Factors ◽

Peritoneal Catheter ◽

Factors Affecting ◽

Vp Shunt ◽

Life Threatening

<p>Ventriculoperitoneal (VP) Shunt is a commonly performed surgical procedure and offers a good result in the treatment of hydrocephalus. In general, 25% of the complication rate of this surgical procedure is abdominal complications. Anal extrusion of a peritoneal catheter is a rare complication ranging from 0.1 to 0.7% of all shunt surgeries. This study presents a rare case of anal extrusion of ventriculoperitoneal shunt in a 1-year-old female child who was asymptomatic. The physical examination revealed swelling and redness along the shunt tract on the retro auricular region, soft abdomen, and no catheter was observed in the anal. This study found several contributing factors affecting the complications in the anal extrusion of a peritoneal catheter, that are thin bowel wall in children and sharp tip and stiff end of VP shunt. The shunt should be disconnected from the abdominal wall, and the lower end should be removed through the rectum by colonoscopy or sigmoidoscopy/proctoscopy or by applying gentle traction on the protruding tube. This study concludes that due to potentially life-threatening consequences and case rarity, thorough anamnesis, physical examination, and objective investigation are needed to determine the appropriate management for anal extrusion of ventriculoperitoneal shunt. </p>

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Subgaleal Migration of the Distal Catheter of a Ventriculoperitoneal Shunt

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.109 ◽

2009 ◽

Vol 52 (2) ◽

pp. 77-79 ◽

Cited By ~ 1

Author(s):

Fatih Serhat Erol ◽

Bekir Akgun

Keyword(s):

Ventriculoperitoneal Shunt ◽

Ventricular Catheter ◽

Peritoneal Catheter ◽

Shunt Valve ◽

Distal Catheter ◽

X Ray ◽

Proximal Migration ◽

Shunt Dysfunction ◽

Valve Placement ◽

The Brain

Proximal migration of the distal end of a ventriculoperitoneal shunt has been observed much more rarely than other numerous shunt-related complications. Subgaleal migration of the peritoneal end is one of the samples. In the preset report we have discussed a case of subgaleal migration of the peritoneal end detected as a result of the examinations performed for shunt dysfunction. There was ventricular dilatation on CT scan of the brain. X-ray examinations confirmed proper ventricular catheter and shunt valve placement but a complete migration of distal (peritoneal) catheter into the subgaleal space. Then the patient’s shunt was revised. When our case and the literature were examined, we observed that this complication was frequently encountered during the first postoperative months, in the pediatric ages and in patients with advanced hydrocephalus. Besides, we have detected that the peritoneal catheters had tendency to migration into the subgaleal tissues similar to pre-insertion forms of the preoperatively original packages.

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Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis

Neurosurgical FOCUS ◽

10.3171/2016.5.focus1637 ◽

2016 ◽

Vol 41 (3) ◽

pp. E7 ◽

Cited By ~ 13

Author(s):

Mingliang He ◽

Leping Ouyang ◽

Shengwen Wang ◽

Meiguang Zheng ◽

Anmin Liu

Keyword(s):

Systematic Reviews ◽

Operative Time ◽

Meta Analysis ◽

Catheter Insertion ◽

Cochrane Library ◽

Number Needed To Treat ◽

Shunt Failure ◽

Peritoneal Catheter ◽

Significant Difference ◽

Mini Laparotomy

OBJECTIVE Ventriculoperitoneal (VP) shunt treatment is the main treatment method for hydrocephalus. The traditional operative approach for peritoneal catheter insertion is mini-laparotomy. In recent years, laparoscopy-assisted insertion has become increasingly popular. It seems likely that use of an endoscope could lower the incidence of shunt malfunction. However, there is no consensus about the benefits of laparoscopy-assisted peritoneal catheter insertion. METHODS A systematic search was performed using the PubMed, Embase, ScienceDirect, and Cochrane Library databases. A manual search for reference lists was conducted. The protocol was prepared according to the interventional systematic reviews of the Cochrane Handbook, and the article was written on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. RESULTS Eleven observational trials and 2 randomized controlled trials were included. Seven operation-related outcome measures were analyzed, and 3 of these showed no difference between operative techniques. The results of the meta-analysis are as follows: in the laparoscopy group, the rate of distal shunt failure was lower (OR 0.41, 95% CI 0.25–0.67; p = 0.0003), the absolute effect is 7.11% for distal shunt failure, the number needed to treat is 14 (95% CI 8–23), operative time was shorter (mean difference [MD], −12.84; 95% CI −20.68 to −5.00; p = 0.001), and blood loss was less (MD −9.93, 95% CI −17.56 to −2.31; p = 0.01). In addition, a borderline statistically significant difference tending to laparoscopic technique was observed in terms of hospital stay (MD −1.77, 95% CI −3.67 to 0.13; p = 0.07). CONCLUSIONS To some extent, a laparoscopic insertion technique could yield a better prognosis, mainly because it is associated with a lower distal failure rate and shorter operative time, which would be clinically relevant.

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