A randomized control trail study has been designed and carried out during the period of July 2014 to October 2016 (27 months) in the Department of Paediatric Surgery, Rajshahi Medical College, Rajshahi, Bangladesh. Twenty Six (26) neonates with myelomeningocele were taken as sample volume. This study was under taken to evaluate the effectiveness of simultaneous ventriculo-peritoneal shunt placement and the sequential shunting. These patients were randomly selected for this study and divided in to two groups. Thirteen patients were undergone repair of myelomeningocele with simultaneous insertion of vetriculo-pritoneal shunt and another 13 patients were undergone only myelomeningocele repair, at first stage. Twelve (12) patients were developed hydrocephalus later that subsequently needed ventriculoperitoneal shunt placement on an average after 31 days. Simultaneous surgery had the advantage of exposing the patients to one rather than two operations. Duration of hospital stay has reduced seven days, though operation time has increased 44 minutes that has not affected the outcome. No difference did exist between two groups but those were shunted simultaneously appeared to enjoy clear benefit. There was significant difference of wound complications like wound breakdown and wound infection between two groups, but wound leakage exclusively occured seven patients in sequentially shunted patients. Shunt related complications were remained same in both groups. There was gross deviation of preoperative OFC (+5.15%) in sequentially shunted patients, which was improved after shunt placement (+2.04%). But, there was significant (P<0.001) difference of OFC between two groups on follow up. Ventricular diameter was rapidly increased (42.65 mm) after repair of myelomeningocele in sequential shunted patients that was reduced after shunt placement but remained at least 7 mm larger than the simultaneous shunted patients. This has also affected the expansion of cortical thickness of brain in sequentially shunted patients which was 3mm less than simultaneously shunted patients. This difference significantly (P<0.01) differ the intelligence quotient. Simultaneously shunted patients also enjoying better health (67%) than sequentially shunted (56%) patients. Simultaneous shunting avoided prolong periods of progressive hydrocephalus compared with those sequentially shunted, thereby averting further cerebral injury and improving intelligence and physical growth.
| Published in | International Journal of Clinical and Experimental Medical Sciences (Volume 6, Issue 4) |
| DOI | 10.11648/j.ijcems.20200604.13 |
| Page(s) | 65-70 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Comparison, Simultaneous V-P Shunting, Sequential V-P Shunting
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APA Style
Md. Nowshad Ali, Mst. Rokeya Khatun, Shah Md. Ahsan Shahid, Md. Kamruzzaman. (2020). An Evaluation of the Effectiveness of Simultaneous Ventriculo-Peritoneal Shunt Placement and the Sequential Shunting- in Neonatal Myelomeningocele. International Journal of Clinical and Experimental Medical Sciences, 6(4), 65-70. https://doi.org/10.11648/j.ijcems.20200604.13
ACS Style
Md. Nowshad Ali; Mst. Rokeya Khatun; Shah Md. Ahsan Shahid; Md. Kamruzzaman. An Evaluation of the Effectiveness of Simultaneous Ventriculo-Peritoneal Shunt Placement and the Sequential Shunting- in Neonatal Myelomeningocele. Int. J. Clin. Exp. Med. Sci. 2020, 6(4), 65-70. doi: 10.11648/j.ijcems.20200604.13
AMA Style
Md. Nowshad Ali, Mst. Rokeya Khatun, Shah Md. Ahsan Shahid, Md. Kamruzzaman. An Evaluation of the Effectiveness of Simultaneous Ventriculo-Peritoneal Shunt Placement and the Sequential Shunting- in Neonatal Myelomeningocele. Int J Clin Exp Med Sci. 2020;6(4):65-70. doi: 10.11648/j.ijcems.20200604.13
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Download@article{10.11648/j.ijcems.20200604.13,
author = {Md. Nowshad Ali and Mst. Rokeya Khatun and Shah Md. Ahsan Shahid and Md. Kamruzzaman},
title = {An Evaluation of the Effectiveness of Simultaneous Ventriculo-Peritoneal Shunt Placement and the Sequential Shunting- in Neonatal Myelomeningocele},
journal = {International Journal of Clinical and Experimental Medical Sciences},
volume = {6},
number = {4},
pages = {65-70},
doi = {10.11648/j.ijcems.20200604.13},
url = {https://doi.org/10.11648/j.ijcems.20200604.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20200604.13},
abstract = {A randomized control trail study has been designed and carried out during the period of July 2014 to October 2016 (27 months) in the Department of Paediatric Surgery, Rajshahi Medical College, Rajshahi, Bangladesh. Twenty Six (26) neonates with myelomeningocele were taken as sample volume. This study was under taken to evaluate the effectiveness of simultaneous ventriculo-peritoneal shunt placement and the sequential shunting. These patients were randomly selected for this study and divided in to two groups. Thirteen patients were undergone repair of myelomeningocele with simultaneous insertion of vetriculo-pritoneal shunt and another 13 patients were undergone only myelomeningocele repair, at first stage. Twelve (12) patients were developed hydrocephalus later that subsequently needed ventriculoperitoneal shunt placement on an average after 31 days. Simultaneous surgery had the advantage of exposing the patients to one rather than two operations. Duration of hospital stay has reduced seven days, though operation time has increased 44 minutes that has not affected the outcome. No difference did exist between two groups but those were shunted simultaneously appeared to enjoy clear benefit. There was significant difference of wound complications like wound breakdown and wound infection between two groups, but wound leakage exclusively occured seven patients in sequentially shunted patients. Shunt related complications were remained same in both groups. There was gross deviation of preoperative OFC (+5.15%) in sequentially shunted patients, which was improved after shunt placement (+2.04%). But, there was significant (P<0.001) difference of OFC between two groups on follow up. Ventricular diameter was rapidly increased (42.65 mm) after repair of myelomeningocele in sequential shunted patients that was reduced after shunt placement but remained at least 7 mm larger than the simultaneous shunted patients. This has also affected the expansion of cortical thickness of brain in sequentially shunted patients which was 3mm less than simultaneously shunted patients. This difference significantly (P<0.01) differ the intelligence quotient. Simultaneously shunted patients also enjoying better health (67%) than sequentially shunted (56%) patients. Simultaneous shunting avoided prolong periods of progressive hydrocephalus compared with those sequentially shunted, thereby averting further cerebral injury and improving intelligence and physical growth.},
year = {2020}
}
TY - JOUR T1 - An Evaluation of the Effectiveness of Simultaneous Ventriculo-Peritoneal Shunt Placement and the Sequential Shunting- in Neonatal Myelomeningocele AU - Md. Nowshad Ali AU - Mst. Rokeya Khatun AU - Shah Md. Ahsan Shahid AU - Md. Kamruzzaman Y1 - 2020/08/04 PY - 2020 N1 - https://doi.org/10.11648/j.ijcems.20200604.13 DO - 10.11648/j.ijcems.20200604.13 T2 - International Journal of Clinical and Experimental Medical Sciences JF - International Journal of Clinical and Experimental Medical Sciences JO - International Journal of Clinical and Experimental Medical Sciences SP - 65 EP - 70 PB - Science Publishing Group SN - 2469-8032 UR - https://doi.org/10.11648/j.ijcems.20200604.13 AB - A randomized control trail study has been designed and carried out during the period of July 2014 to October 2016 (27 months) in the Department of Paediatric Surgery, Rajshahi Medical College, Rajshahi, Bangladesh. Twenty Six (26) neonates with myelomeningocele were taken as sample volume. This study was under taken to evaluate the effectiveness of simultaneous ventriculo-peritoneal shunt placement and the sequential shunting. These patients were randomly selected for this study and divided in to two groups. Thirteen patients were undergone repair of myelomeningocele with simultaneous insertion of vetriculo-pritoneal shunt and another 13 patients were undergone only myelomeningocele repair, at first stage. Twelve (12) patients were developed hydrocephalus later that subsequently needed ventriculoperitoneal shunt placement on an average after 31 days. Simultaneous surgery had the advantage of exposing the patients to one rather than two operations. Duration of hospital stay has reduced seven days, though operation time has increased 44 minutes that has not affected the outcome. No difference did exist between two groups but those were shunted simultaneously appeared to enjoy clear benefit. There was significant difference of wound complications like wound breakdown and wound infection between two groups, but wound leakage exclusively occured seven patients in sequentially shunted patients. Shunt related complications were remained same in both groups. There was gross deviation of preoperative OFC (+5.15%) in sequentially shunted patients, which was improved after shunt placement (+2.04%). But, there was significant (P<0.001) difference of OFC between two groups on follow up. Ventricular diameter was rapidly increased (42.65 mm) after repair of myelomeningocele in sequential shunted patients that was reduced after shunt placement but remained at least 7 mm larger than the simultaneous shunted patients. This has also affected the expansion of cortical thickness of brain in sequentially shunted patients which was 3mm less than simultaneously shunted patients. This difference significantly (P<0.01) differ the intelligence quotient. Simultaneously shunted patients also enjoying better health (67%) than sequentially shunted (56%) patients. Simultaneous shunting avoided prolong periods of progressive hydrocephalus compared with those sequentially shunted, thereby averting further cerebral injury and improving intelligence and physical growth. VL - 6 IS - 4 ER -
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