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Abstract: Objective: To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt. Method: The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed. Results: After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared), 25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP) shunt. Three subjects had a history of infection following VP shunting. Conclusion: LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications.

[1]Aoki, N., 1990. Lumboperitoneal shunt: clinical application, complications, and comparison with ventriculoperitoneal shunt. Neurosurgery, 26(6):998-1004.

[2]Chumas, P., Kulkarni, M., Drake, J., Hoffman, H., Humphreys, R., Rutka, J., 1993. Lumboperitoneal shunting: a retrospective study in the pediatric population. Neurosurgery, 32(3):376-383.

[3]Copeland, G., Foy, P., Shaw, M., 1982. The incidence of epilepsy after ventricular shunting operations. Surg. Neurol., 17(4):279-281.

[4]Dan, N., Wade, M., 1986. The incidence of epilepsy after ventricular shunting procedures. J. Neurosurg., 65(1):19-21.

[5]Eisenberg, H., Davidson, R., Shillto, J., 1971. Lumboperitoneal shunts review of 34 cases. J. Neurosurg., 35(4):427-431.

[6]Ferguson, A., 1898. Intraperitoneal diversion of the cerebrospinal fluid in cases of hydrocephalus. N. Y. Med. J., 67(2):902.

[7]Jones, R.F.C., 1967. Long-term results in various treatments of hydrocephalus. J. Neurosurg., 26(3):313-315.

[8]Lamprecht, D., Schoeman, J., Donald, P., 2001. Ventriculoperitoneal shunting in childhood tuberculous meningitis. Br. J. Neurosurg., 15(2):119-125.

[9]Li, W., 2009. Experiences of treatment for shunt apparatus blockage after ventriculoperitoneal shunt-treated hydrocephalus: 14 cases report. Chin. J. Pract. Nerv. Dis., 14(1):20-22 (in Chinese).

[10]Matson, D.D., 1949. A new operation for the treatment of communicating hydrocephalus: report of a case secondary to generalized meningitis. J. Neurosurg., 6(3):238-247.

[11]Murtagh, F., Lehman, R., 1967. Peritoneal shunts in management of hydrocephalus. JAMA, 202(11):1010-1014.

[12]Schmidek, H., 2000. Operative Neurosurgical Techniques, 4th Ed. Wang, R., Yu, C., Xu, B., Zhang, Y., translators, 2003. People’s Medical Publishing House, Beijing, China, p.576 (in Chinese).

[13]Sood, S., Lokuketagoda, J., Ham, S., 2005. Periventricular ridity in long-term shunt-treated hydrocephalus. J. Neurosurg., 102(2):146-149.

[14]Spetzler, R., Wilson, C., Grollmus, J., 1975. Percutaneous lumboperitoneal shunt. J. Neurosurg., 43(6):770-773.

[15]Spetzler, R., Wilson, C., Schulte, R., 1977. Simplified percutaneous lumboperitoneal shunting. Surg. Neurol., 7(1):25-29.

[16]Wang, V., Barbaro, N., Lawton, M., Pitts, L., Kunwar, S., Parsa, A., Gupta, N., McDermott, M., 2007. Complications of lumboperitoneal shunts. Neurosurgery, 60(6):1045-1049.

[17]Yadav, Y., Pande, S., Raina, V., Singh, M., 2004. Lumboperitoneal shunts: review of 409 cases. Neurol. India, 52(2):188-190.

[18]Zhang, K., Zhang, G., Su, C., Zhang, S., Liu, J., Zhou, L., 1996. Lumboperitoneal shunt for posttraumatic hydrocephalus. Chin. J. Neurosurg., 12(6):357-359 (in Chinese).