Background: Few studies in Japan have compiled and statistically analyzed data on shunt survival time and risk factors for shunt failure in ventriculoperitoneal shunts (VPS) for pediatric hydrocephalus.
Methods: We statistically analyzed the long-term results of VPS placement at our institution and the factors that led to shunt failure. Data were retrospectively collected from patients aged 18 years or younger with a VPS installed at our facility between January 2012 and December 2022. The period until reconstruction in all cases was analyzed using the Kaplan-Meier method. In addition, univariate analysis was performed using Log Rank (Mantel-Cox) test, and multivariate analysis was performed using the Cox regression proportional hazards model.
Results: A total of 167 patients were included, and 19 patients who died or discontinued follow-up were censored. The 1-year and 2-year survival rates (95% confidence interval) were 82.3% (76.2-88.4%) and 78.4% (71.7-85.1%), respectively. Univariate and multivariate analysis showed that no significant risk factors for shunt failure. On the other hand, the age at the time of shunt failure was 1.83 years for anterior horn puncture group and 5.19 years for posterior horn puncture group (P = 0.022).
Conclusion: This analysis did not reveal any significant risk factors for shunt failure. However, the age at the time of shunt failure after posterior horn puncture was significantly higher. We therefore believe that it is necessary to devise ways to reduce the effect of increased height, such as by creating a curve.
"},{"@language":"ja","@value":"当施設でのVPSの長期成績および再建例の要因について，2012年1月から2022年12月のVPS新規施行例を対象に後方視的に検討，全症例の再建までの期間をKaplan-Meier法で解析した．本解析では単変量および多変量解析でシャント生存期間を有意に短縮させる因子は認めなかった．また後角穿刺において，シャント不全時の年齢が前角穿刺に比べて高かった．成長期のチューブへの影響が示唆されることから，カーブの作成など身長増大による影響を減らす工夫をすることで合併症リスクを低減できる可能性があると考える．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410304084580949762","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"圓谷 研人"},{"@language":"en","@value":"Tsuburaya Kento"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Kanagawa Children's Medical Center"},{"@language":"ja","@value":"神奈川県立こども医療センター脳神経外科"},{"@language":"en","@value":"Department of Neurosurgery, Yokohama City University School of Medicine"},{"@language":"ja","@value":"横浜市立大学大学院医学研究科脳神経外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410304084580949763","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"広川 大輔"},{"@language":"en","@value":"Hirokawa Daisuke"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Kanagawa Children's Medical Center"},{"@language":"ja","@value":"神奈川県立こども医療センター脳神経外科"},{"@language":"en","@value":"Department of Neurosurgery, Yokohama City University School of Medicine"},{"@language":"ja","@value":"横浜市立大学大学院医学研究科脳神経外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410304084580949760","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"矢澤 理"},{"@language":"en","@value":"Yazawa Osamu"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Kanagawa Children's Medical Center"},{"@language":"ja","@value":"神奈川県立こども医療センター脳神経外科"},{"@language":"en","@value":"Department of Neurosurgery, Yokohama City University School of Medicine"},{"@language":"ja","@value":"横浜市立大学大学院医学研究科脳神経外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410304084580949764","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"福山 龍太郎"},{"@language":"en","@value":"Fukuyama Ryutaro"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Kanagawa Children's Medical Center"},{"@language":"ja","@value":"神奈川県立こども医療センター脳神経外科"},{"@language":"en","@value":"Department of Neurosurgery, Yokohama City University School of Medicine"},{"@language":"ja","@value":"横浜市立大学大学院医学研究科脳神経外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410304084580949761","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"佐藤 博信"},{"@language":"en","@value":"Sato Hironobu"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, Kanagawa Children's Medical Center"},{"@language":"ja","@value":"神奈川県立こども医療センター脳神経外科"},{"@language":"en","@value":"Department of Neurosurgery, Yokohama City University School of Medicine"},{"@language":"ja","@value":"横浜市立大学大学院医学研究科脳神経外科学"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"03878023"},{"@type":"EISSN","@value":"2435824X"}],"prism:publicationName":[{"@language":"ja","@value":"小児の脳神経"},{"@language":"en","@value":"Nervous System in Children"},{"@language":"ja","@value":"小児の脳神経"},{"@language":"en","@value":"Nervous System in Children"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society for Pediatric Neurosurgery"},{"@language":"ja","@value":"一般社団法人 日本小児神経外科学会"}],"prism:publicationDate":"2025","prism:volume":"50","prism:number":"1","prism:startingPage":"1","prism:endingPage":"5"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2025235735"}],"availableAt":"2025","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=pediatric%20hydrocephalus","dc:title":"pediatric hydrocephalus"},{"@id":"https://cir.nii.ac.jp/all?q=VP%20shunt","dc:title":"VP shunt"},{"@id":"https://cir.nii.ac.jp/all?q=shunt%20survival%20duration","dc:title":"shunt survival duration"},{"@id":"https://cir.nii.ac.jp/all?q=risk%20factors%20of%20shunt%20failure","dc:title":"risk factors of shunt failure"},{"@id":"https://cir.nii.ac.jp/all?q=pediatric%20hydrocephalus","dc:title":"pediatric hydrocephalus"},{"@id":"https://cir.nii.ac.jp/all?q=VP%20shunt","dc:title":"VP shunt"},{"@id":"https://cir.nii.ac.jp/all?q=shunt%20survival%20duration","dc:title":"shunt survival duration"},{"@id":"https://cir.nii.ac.jp/all?q=risk%20factors%20of%20shunt%20failure","dc:title":"risk factors of shunt failure"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2014037705"}]}