To determine the short-term outcome of combined Ventriculoperitoneal Shunting and Myelomeningocele repair at the University Teaching Hospital

Abstract

Background and Objective: There is paucity of data on the outcome of combined VPS insertion and myelomeningocoele repair, and whether this will reduce morbidity and mortality. This study was designed to address this research question. Method: Prospective descriptive interventional study was used and patients were recruited between January and October 2009, giving a total of 22. Information on sociodemographic, referral status, preoperative and postoperative outcome was documented and analysed.Result: Males constituted 54.7% and females 45.2% of cases. The youngest age at presentation was 1 week, the oldest was 32 weeks. The majority (90%) were referred from clinics and hospitals outside Lusaka, and most hail from poor socioeconomic backgrounds (64%). The malformation occurred in the lumbar and sacral regions in 77.4%. Most of the patients presented with normal and mild forms of neurological impairment. Ultrasound examination showed that 90% had mild findings and 9% had moderate form of hydrocephalus. All patients were shunted and had surgical closure of the sac. Postoperative complications were seen in patients who had oedamatous (59%) and infected wounds (9%). One patient had CSF leakage and later died of meningitis. Average hospital stay for all patients was 25days.Conclusion: Being the only referral hospital and the only centre with neurosurgical unit for all public institutions, children born with such defects outside Lusaka will continue being seen late.Although the sample size was small, it could show that even when they come late, a combined surgical approach can still be recommended in such patients. Most of the patients operated on recovered well postoperatively, but period of hospital stay was too