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Outcomes of ventriculoperitoneal shunt surgery for hydrocephalus in children in low- and middle-income countries: a systematic review

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Názov: Outcomes of ventriculoperitoneal shunt surgery for hydrocephalus in children in low- and middle-income countries: a systematic review
Autori: Benjamin Mukumbya, Amos O. Adeleye, Afnan Hassab E. Siddig, Robert H. Mbilinyi, Joshua Woo, Chibueze Agwu, Wai Yan Min Htike, Mubarak Jolayemi Mustapha, Olaoluwa Ezekiel Dada, Samantha Ramos, Christopher Adereti, Joseph Mary Ssembatya, Zoey Petitt, Megan E. H. Still, Elizabeth R. Blackwood, Megan von Isenburg, Michael M. Haglund, Alvan-Emeka K. Ukachukwu
Zdroj: Journal of Neurosurgery: Pediatrics. :1-12
Informácie o vydavateľovi: Journal of Neurosurgery Publishing Group (JNSPG), 2025.
Rok vydania: 2025
Popis: OBJECTIVE Improving outcomes for pediatric patients with hydrocephalus in low- and middle-income countries (LMICs) requires research on ventriculoperitoneal shunt (VPS) complications and outcomes that may be comparable to studies conducted in high-income countries (HICs). The authors aimed to address this gap by conducting a systematic review to analyze VPS complications and outcomes among pediatric patients in LMICs. METHODS This review adhered to PRISMA guidelines and the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) quality assessment. The authors screened English-language publications on pediatric VPS surgeries in LMICs, excluding studies from HICs and adult populations (> 18 years), using 6 databases: PubMed/Medline, Embase, Cochrane Library, Web of Science, Global Index Medicus, and Google Scholar. The search was completed on August 31, 2023. Data extraction included patient demographics, diagnosis, management, complications, and outcomes. Descriptive analyses were performed using Google Spreadsheets and R. RESULTS A total of 590 studies were included, revealing trends in VPS utilization across 6 continents. Among 25,950 patients, the majority were aged 0–5 years (13,044/15,008, 86.9%), with a slight male predominance (11,043/19,971, 55.3%). Key complications included infections (mainly involving Staphylococcus spp.), shunt failure, and obstruction. Outcomes were reported for 7185 patients, representing 27.7% of the total cohort. Favorable outcomes were observed in 68.1% (4893 patients) and unfavorable outcomes in 13.1% (938 patients), and the overall mortality rate was 18.8% (1354 patients). CONCLUSIONS This review provides a comprehensive profile of VPS complications and outcomes in pediatric patients in LMICs. Despite a predominance of observational studies, these findings offer critical insights that may inform health policy and practice in LMICs. Future research should prioritize longitudinal studies to explore long-term outcomes, develop cost-effective approaches to reduce complications, and foster international collaborations to strengthen global neurosurgical capacity.
Druh dokumentu: Article
ISSN: 1933-0715
1933-0707
DOI: 10.3171/2025.4.peds24598
Prístupové číslo: edsair.doi...........660541be6d1508ac1e5403ff1c6f1493
Databáza: OpenAIRE
Popis
Abstrakt:OBJECTIVE Improving outcomes for pediatric patients with hydrocephalus in low- and middle-income countries (LMICs) requires research on ventriculoperitoneal shunt (VPS) complications and outcomes that may be comparable to studies conducted in high-income countries (HICs). The authors aimed to address this gap by conducting a systematic review to analyze VPS complications and outcomes among pediatric patients in LMICs. METHODS This review adhered to PRISMA guidelines and the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) quality assessment. The authors screened English-language publications on pediatric VPS surgeries in LMICs, excluding studies from HICs and adult populations (> 18 years), using 6 databases: PubMed/Medline, Embase, Cochrane Library, Web of Science, Global Index Medicus, and Google Scholar. The search was completed on August 31, 2023. Data extraction included patient demographics, diagnosis, management, complications, and outcomes. Descriptive analyses were performed using Google Spreadsheets and R. RESULTS A total of 590 studies were included, revealing trends in VPS utilization across 6 continents. Among 25,950 patients, the majority were aged 0–5 years (13,044/15,008, 86.9%), with a slight male predominance (11,043/19,971, 55.3%). Key complications included infections (mainly involving Staphylococcus spp.), shunt failure, and obstruction. Outcomes were reported for 7185 patients, representing 27.7% of the total cohort. Favorable outcomes were observed in 68.1% (4893 patients) and unfavorable outcomes in 13.1% (938 patients), and the overall mortality rate was 18.8% (1354 patients). CONCLUSIONS This review provides a comprehensive profile of VPS complications and outcomes in pediatric patients in LMICs. Despite a predominance of observational studies, these findings offer critical insights that may inform health policy and practice in LMICs. Future research should prioritize longitudinal studies to explore long-term outcomes, develop cost-effective approaches to reduce complications, and foster international collaborations to strengthen global neurosurgical capacity.
ISSN:19330715
19330707
DOI:10.3171/2025.4.peds24598