Outcomes of ventriculoperitoneal shunt and lumboperitoneal shunt for communicating hydrocephalus

JIANG Hai-tao; JI Zhen-gang; XIAO Yi-lei; YIN Guo-yang; FU Qiang

doi:10.13798/j.issn.1009-153X.2025.04.002

Abstract：Objective To compare and analyze the efficacy and safety of ventriculoperitoneal shunt(VPS)versus lumboperitoneal shunt(LPS)in the treatment of communicating hydrocephalus.Methods The clinical data of 102 patients with communicating hydrocephalus admitted between January 2020 and June 2022 were retrospectively analyzed.Eighty-two cases underwent VPS and 20 cases received LPS,with postoperative follow-up for 12 months.At 12 months postoperatively,Glasgow Coma Scale(GCS)scores,Evans index,modified Rankin Scale(mRS)scores,and National Institutes of Health Stroke Scale(NIHSS)scores were evaluated.Prognosis was assessed using symptom improvement score(SIS),with full score of 10 and SIS≥5 indicating good prognosis.Results Both groups showed significant clinical improvement postoperatively.At 12-month follow-up,both groups demonstrated significant improvements in GCS scores,Evans index,mRS scores,and NIHSS scores(P<0.05),with no statistically significant differences between the two groups(P>0.05).The good prognosis rate showed no statistical difference between VPS group(84.1%)and LPS group(75.0%;P=0.525).In VPS group,good prognosis rates were significantly higher in patients with mild consciousness disturbance[100.0%(48/48)]and moderate consciousness disturbance[93.8%(15/16)]compared to those with severe consciousness disturbance[33.3%(6/18);P<0.001].In LPS group,good prognosis rate was significantly higher in patients with mild-moderate consciousness disturbance[100.0%(11/11)]than in those with severe disturbance[44.4%(4/9);P=0.020].There were no statistically significant differences in the incidences of intracranial hemorrhage,epilepsy,shunt obstruction,and intracranial infection between the two groups 12 months after surgery(P>0.05).Conclusions Both VPS and LPS are effective treatments for communicating hydrocephalus.For patients with severe consciousness disturbance,preoperative active evaluation of shunt effectiveness and strict adherence to surgical indications are crucial.