Comparison of Ventriculoperitoneal Shunt and Lumboperitoneal Shunt for Post- hemorrhagic Hydrocephalus: A Retrospective Analysis of Long-term outcomes

Background Ventriculoperitoneal shunt (VPS) implantation stands as the prevailing therapy for individuals afflicted with post-hemorrhagic hydrocephalus (PHH). This study aims to meticulously scrutinize and juxtapose the enduring effectiveness and safety profiles of VPS and lumboperitoneal shunts (LPS) in addressing PHH. Materials and Methods We conducted a retrospective analysis of adult PHH patients who underwent shunt surgery at two centers from 2014 to 2018. The primary outcome was the shunt failure rate at 3 years after surgery. The secondary outcomes included postoperative complications, Evans index, and mRS score. In this study, positive response was defined as an improvement of 1 point or more in the postoperative mRS score, and a favorable outcome was defined as an mRS score of ≤3 points. Results A total of 273 patients were included: 177 patients receiving VPS and 96 patients receiving LPS surgery. The study showed that the VPS and LPS groups were at a similar baseline. At 3 years after surgery, the shunt failure rate in the VPS group was 15.3%, lower than that in the LPS group (27.1%) with a statistically significant difference ( P =0.018). 138 patients (78.0%) in the VPS group and 60 patients (62.5%) in the LPS group had positive response, with a statistically significant difference between the two groups ( P =0.007). The incidence of over-drainage in the VPS group was lower than that in the LPS group ( P =0.028). Conclusion These discernments unequivocally advocate for VPS as the preferred therapeutic modality over LPS in managing PHH.