Safety, Efficacy, and Cost-Analysis of Percutaneous Endoscopic Gastrostomy and Ventriculoperitoneal Shunt Placement in a Simultaneous Surgery
Copyright © 2018 Elsevier Inc. All rights reserved..
BACKGROUND: Limited historical data suggest that concomitant placement of both a ventriculoperitoneal (VP) shunt and percutaneous endoscopic gastrostomy (PEG) tube is associated with an increased risk of complications, including VP shunt infections. Here we compare the outcomes and cost difference between 2 groups of patients, one in which a VP shunt and PEG tube were placed in the same operation and the other in which separate operations were performed.
METHODS: A total of 10 patients underwent simultaneous placement of a VP shunt and PEG tube. This group was compared with a group of 18 patients that underwent separate placements. Hospital billing charges were used to compare the total cost of the procedures in the 2 groups.
RESULTS: Eight of the 10 patients presented with aneurysmal subarachnoid hemorrhage. The average length of stay was 25 ± 2 days for the simultaneous procedure group and 43 ± 7 days for the separate procedures group. The average duration of follow-up was 12 ± 3 months after simultaneous placement. No patient in the simultaneous surgery group had signs of infection or shunt malfunction at last follow-up. The overall complication rate was significantly lower in the simultaneous surgery group. A cost analysis demonstrated significant cost savings by completing both procedures in the same surgical procedure.
CONCLUSIONS: Simultaneous placement of a PEG tube and VP shunt is safe, efficacious, and cost-effective. Thus, in patients requiring both a VP shunt and PEG tube, placement of both devices in a single surgical procedure should be considered.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:115 |
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| Enthalten in: |
World neurosurgery - 115(2018) vom: 30. Juli, Seite e233-e237 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jack, Megan M [VerfasserIn] |
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| Links: |
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| Themen: |
Hydrocephalus |
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| Anmerkungen: |
Date Completed 03.08.2018 Date Revised 03.08.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.wneu.2018.04.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM28304571X |
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| 100 | 1 | |a Jack, Megan M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Safety, Efficacy, and Cost-Analysis of Percutaneous Endoscopic Gastrostomy and Ventriculoperitoneal Shunt Placement in a Simultaneous Surgery |
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| 500 | |a Date Completed 03.08.2018 | ||
| 500 | |a Date Revised 03.08.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Limited historical data suggest that concomitant placement of both a ventriculoperitoneal (VP) shunt and percutaneous endoscopic gastrostomy (PEG) tube is associated with an increased risk of complications, including VP shunt infections. Here we compare the outcomes and cost difference between 2 groups of patients, one in which a VP shunt and PEG tube were placed in the same operation and the other in which separate operations were performed | ||
| 520 | |a METHODS: A total of 10 patients underwent simultaneous placement of a VP shunt and PEG tube. This group was compared with a group of 18 patients that underwent separate placements. Hospital billing charges were used to compare the total cost of the procedures in the 2 groups | ||
| 520 | |a RESULTS: Eight of the 10 patients presented with aneurysmal subarachnoid hemorrhage. The average length of stay was 25 ± 2 days for the simultaneous procedure group and 43 ± 7 days for the separate procedures group. The average duration of follow-up was 12 ± 3 months after simultaneous placement. No patient in the simultaneous surgery group had signs of infection or shunt malfunction at last follow-up. The overall complication rate was significantly lower in the simultaneous surgery group. A cost analysis demonstrated significant cost savings by completing both procedures in the same surgical procedure | ||
| 520 | |a CONCLUSIONS: Simultaneous placement of a PEG tube and VP shunt is safe, efficacious, and cost-effective. Thus, in patients requiring both a VP shunt and PEG tube, placement of both devices in a single surgical procedure should be considered | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hydrocephalus | |
| 650 | 4 | |a Infection | |
| 650 | 4 | |a Percutaneous endoscopic gastrostomy | |
| 650 | 4 | |a VP shunt | |
| 650 | 4 | |a Ventriculoperitoneal shunt | |
| 700 | 1 | |a Peterson, Jeremy C |e verfasserin |4 aut | |
| 700 | 1 | |a McGinnis, J P |e verfasserin |4 aut | |
| 700 | 1 | |a Alley, John |e verfasserin |4 aut | |
| 700 | 1 | |a Chamoun, Roukoz B |e verfasserin |4 aut | |
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