title: Staged operations for posthemorrhagic hydrocephalus in extremely low-birth-weight infants with preceding stoma creation after bowel perforation: surgical strategy.
abstract: METHODS
  We report a complicated extremely low-birth-weight (ELBW) infant with posthemorrhagic hydrocephalus after intraventricular hemorrhage and preceding stoma creation after bowel perforation who was treated with staged operations, including shunting and external ventricular drainage. The first operation was a temporary valveless ventriculoperitoneal (VP) shunt placement until the time of the stoma closure. The stoma was successfully closed 3 months after the first operation when the peritoneal tube was drawn out from the chest wall and the VP shunt system was temporarily used as an external drainage with a long subcutaneous tunnel. One month after the second operation, final VP shunt placement was performed after good healing of bowel anastomosis was surely confirmed. The previous peritoneal shunt tube was cut behind the ear, removed, and replaced with a valve-regulated VP shunt system.
  
  
  CONCLUSIONS
  This staged strategy is a safe and feasible option for complicated ELBW infants with preceding stoma and hydrocephalus.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, Japan. snakano@fc.miyazaki-u.ac.jp
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakano
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Takuma
authors.initials: T
authors.lastname: Kawasoe
authors.forename: Asako
authors.initials: A
authors.lastname: Koreeda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kondo
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Kai
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Wakisaka
mesh_terms: D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000209:etiology*; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000601:surgery*; D011247:Pregnancy; D054047:Surgical Stomas; D014463:Ultrasonography; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*