title: Does the Simultaneous Use of a Neuroendoscope Influence the Incidence of Ventriculoperitoneal Shunt Infection?
abstract: BACKGROUND
  The relationship between the use of an endoscope during ventriculoperitoneal shunt (VPS) procedures and infection remains poorly defined. In this study, we sought to analyze whether the simultaneous use of an endoscope could in fact increase the infection rate associated with VPS procedures.
  
  
  METHODS
  This study included 438 VPS procedures, 49 in which an endoscope was used (11.2%) and 389 in which an endoscope was not used (88.8%). The infection rates in these 2 main groups were calculated and compared. Subsequently, 4 new groups were created, composed of patients with a shunt inserted for the first time (groups 1A and 1B) and patients with a shunt reviewed or inserted for a second time (groups 2A and 2B). Groups 1A and 2A comprised patients in whom an endoscope was used simultaneously with VPS surgery, and groups 1B and 2B comprised patients in whom an endoscope was not used. These groups were compared to determine the infection rate.
  
  
  RESULTS
  The overall infection rate was 18.5%, including 22.4% in the groups in which an endoscope was used and 18% in those in which an endoscope was not used (P = 0.449). Groups 1A and 1B and groups 2A and 2B were matched for possible intervening risk factors. The infection rate was 28.6% in group 1A and 16.2% in group 1B (P = 0.27), and 20% in group 2A and 19.8% in group 2B (P = 0.977).
  
  
  CONCLUSIONS
  In the present study, the use of an endoscope during VPS procedures did not increase the risk of surgical infection.
authors.affiliation: Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Neurosurgery Service, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Electronic address: agjg@terra.com.br.
authors.forename: Alexandre Varella
authors.initials: AV
authors.lastname: Giannetti
authors.affiliation: Infection Control Service, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Fabiana Guerra
authors.initials: FG
authors.lastname: Pimenta
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Infection Control Service, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Wanessa Trindade
authors.initials: WT
authors.lastname: Clemente
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044582:Neuroendoscopes / Q000009:adverse effects / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000453:epidemiology*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects
keywords: Hydrocephalus; Infection; Neuroendoscopy; Ventriculoperitoneal shunt