title: Shunt revisions in children--can they be avoided? Experiences from a population-based study.
abstract: BACKGROUND
  Shunt failure is by far the most frequent problem in children with shunts, and most of them will experience this condition at some point in their lives. In order to identify causes of shunt failure, and to compare multi-component and one-piece shunt systems, we analyzed retrospectively all pediatric shunt procedures in our Department during an 11-year period. The study does not deal with shunt infections.
  
  
  METHODS
  We reviewed the records of all pediatric shunting procedures between January 1986 and December 1996.
  
  
  RESULTS
  The study included 161 children operated for hydrocephalus with a total of 431 procedures. The procedures included 124 (29%) primary insertions, 10 (2%) reinsertions and 297 (69%) revisions; 206 (69%) of the revisions were due to shunt failures, of which 74 (36%) were caused by the failure of the surgical technique (misplaced ventricular catheters, disconnected shunts, or misplaced peritoneal catheters).
  
  
  CONCLUSIONS
  Improvement of the surgical technique may reduce the incidence of shunt failures and revisions. The results obtained in a small department like ours do not seem to differ substantially from those obtained in more specialized departments with a larger patient group. Practical measures that may reduce the risk of shunt failures are suggested.
authors.affiliation: Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
authors.forename: Per Ø
authors.initials: PØ
authors.lastname: Enger
authors.forename: Frode
authors.initials: F
authors.lastname: Svendsen
authors.forename: Kristian
authors.initials: K
authors.lastname: Sommerfelt
authors.forename: Knut
authors.initials: K
authors.lastname: Wester
mesh_terms: D000293:Adolescent; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control* / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors