Resumen de Complicaciones en el tratamiento quirúrgico de pacientes pediátricos con hidrocefalia operados en el Hospital Nacional Guillermo Almenara Irigoyen

Estela Erwinovna Mogrovejo, Patricia Pichilingue Reto, Quiches Bazán, Betty Quintanilla Cabrera

• español

  Objetivo: Determinar las principales complicaciones postquirurgicas en pacientes pediatricos con hidrocefalia en el Hospital Nacional Guillermo Almenara Irigoyen.

  Material y metodo: Estudio descriptivo, de tipo serie de casos que incluyo las historias clinicas de pacientes post operados por hidrocefalia mediante la derivacion ventriculoperitoneal, entre 0 y 14 anos al momento de la primera intervencion quirurgica en la institucion indicada. Los datos fueron recolectados en una ficha estandarizada. Se acepto como significancia estadistica p<0,05.

  Resultados: Se encontro complicaciones en 35,5% de los pacientes. De las complicaciones 54% fueron tempranas y 45% tardias. Las causas fueron: disfuncion del sistema, infeccion y hematoma subdural debido a sobredrenaje, 54,5%, 27,3% y 18,2% respectivamente. De los pacientes con complicaciones: 54,5% tenian hidrocefalia adquirida y 45,5% congenita; 72,7% fueron intervenidos de emergencia y 27,3% de manera electiva. Se encontro asociacion estadisticamente significativa entre la etiologia de la hidrocefalia y las complicaciones registradas �Ô2 = 5,387 (p = 0,02).

  Conclusiones: Se encontro una frecuencia de 35,5% de complicaciones post quirurgicas, siendo la disfuncion del sistema la complicacion mas frecuente en este escenario. Los resultados indican que la hidrocefalia adquirida presenta mayor riesgo de presentar complicaciones postquirurgicas que la congenita.

• English

  Objective: To determine the main surgical complications in pediatric patients with hydrocephalus in Guillermo Almenara Irigoyen National Hospital.

  Material and method: A descriptive case series reviewed the charts of pediatric patients with hydrocephalus who underwent a ventriculo-peritoneal shunt procedure. These patients were between 0 and 14 years old when they had their first surgery. Data was collected in a standardized chart. Statistical significance was established in p<0.05.

  Results: Approximately one third of patients (35.5%) developed complications. Fifty- four percent had early complications and 45% developed late complications. Causes for complications were: system malfunction, infection and subdural hematoma caused by overdrainage of VP shunts in 54.5%, 27.3% and 18.2%, respectively. Of all patients who developed complications, 54.5% had acquired and 45.5% had congenital hydrocephalus; 72.7% underwent emergency surgery and 27.3% underwent elective surgery. There was a statistically significant association between the origin of hydrocephalus and the development of complications, ÷2 = 5.387 (p = 0.02).

  Conclusions: The frequency of complications after surgical therapy for hydrocephalus was 35.5%. The main cause was system malfunction. These results show that acquired hydrocephalus has a greater likelihood for developing post surgical complications compared to congenital hydrocephalus.