Clinical Characteristics, Outcomes, Revision Rates, and Economic Impact of Ventricular Shunt Surgery in Pediatric Patients

Objective To describe the clinical features, treatment modalities, and frequency of surgical revisions in pediatric patients who underwent ventricular shunt procedures. Methods A retrospective, descriptive, observational study was conducted at the Hospital de Pediatría "Dr. Silvestre Frenk Freund," National Medical Center "Siglo XXI." Medical records of 371 patients aged 0–16 years who underwent ventricular cerebrospinal fluid diversion surgeries between January 2013 and May 2021 were analyzed. Demographic data, etiology, surgical modality, and revision frequency were collected and analyzed using descriptive statistics. Results Among the 371 patients, 59% were male and 41% were female. The primary etiologies were congenital malformations (37%), neoplasms (24%), hemorrhage (14%), infections (10%), trauma (5%), cysts (5%), and idiopathic causes (4%). Of the cohort, 59.8% required only one surgery, while 40.2% underwent multiple surgical interventions, with a maximum of 22 surgeries in one patient. Initial treatment predominantly involved external ventricular drainage (50.2%), followed by ventriculoperitoneal shunt placement (41.0%). Notably, 38% of patients with initial ventriculoperitoneal shunt placement required at least one revision surgery. Conclusion Ventricular shunt surgery remains a critical intervention in pediatric neurosurgery, often requiring multidisciplinary management. Despite advancements, a significant proportion of patients require multiple interventions, highlighting the need for improved surgical techniques and postoperative care strategies. This study provides a foundation for future prospective studies aimed at reducing revision rates and improving outcomes.