[Ventriculoperitoneal and ventriculoatrial shunts in treatment of patients with brain tumors].

Two 234 patients with tumor-associated hydrocephalus underwent their first shunt implantation at Burdenko Neurosurgery Institute between 2004 and 2008. Age of the patients ranged from 18 to 77 years (mean 44). The follow-up was available in 162 patients (72%). The median follow-up was 10 months. Shunt failure occurred in 29,2% of 162 patients. Kaplan-Mayer analysis showed that the probability of shunt failure free interval was 72, 69, 60% at one, two and three years after insertion, respectively. The most frequent cause of shunt failure was malposition of the ventricular catheter (30,6%), occlusion of the ventricular and abdominal catheter occurred in 20,4 and 22,2%, respectively. Shunt infection was encountered in 24,5% of cases. Among the analyzed factors (position of the catheter within the ventricle, additional operations such as tumor resection, implantation of external ventricular drain before shunt surgery, malignancy of the tumor and type of hydrocephalus) only presence of external ventricular drain increased the risk of shunt infection. The duration of external drainage positively correlated with the risk of shunt infection. In most cases shunt failure can be prevented. The results of the study may help the surgeon to choose the optimal treatment strategy for patient with tumor-associated hydrocephalus.