title: Simultaneous repair of myelomeningocele and shunt insertion.
abstract: METHODS
  Simultaneous shunt placement and neural tube repair are described and compared with a concomitant series of patients with delayed shunting. Twenty-eight patients with a myelomeningocele underwent closure of neural tube defects at our Institution from 1998 to 2001. Eleven patients (Group 1) had concomitant surgery performed after birth. Group 2 (7 out of 28) included patients without hydrocephalus at birth, in Group 3 (4 out of 28) the children did not develop hydrocephalus, and Group 4 (6 out of 28) patients were born outside our hospital and referred for surgical care after birth.
  
  
  CONCLUSIONS
  Simultaneous insertion of shunt and correction of a myelomeningocele do not pose an additional risk to the child and do have some advantages, facilitating healing of the back without CSF leakage and protecting the brain from the effects of progressive ventricular dilatation. Patients with a myelomeningocele born outside the hospital are prone to infectious complications.
authors.affiliation: Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, The Hospital of Clinics, Faculty of Medicine Ribeirão Preto, University of Sao Paulo, Av. Bandeirantes 3900, CEP: 14049-900 Sao Paulo, Brazil. hrmachad@fmrp.usp.br
authors.forename: Hélio Rubens
authors.initials: HR
authors.lastname: Machado
authors.forename: Ricardo
authors.initials: R
authors.lastname: Santos de Oliveira
mesh_terms: D002557:Cerebrospinal Fluid Shunts; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D007239:Infections / Q000209:etiology; D008591:Meningomyelocele / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants; D014945:Wound Healing