RESUMO
BACKGROUND AND OBJECTIVES: Antibiotic-impregnated shunts seem to be beneficial in preventing bacterial infections and decreasing mortality by effectively inhibiting microbial growth in the shunt system and reducing the risk of shunt-associated infections. This study aimed to evaluate the efficacy of antibiotic-impregnated shunt catheters (AISC) in reducing the incidence of bacterial shunt infection in patients with hydrocephalus. METHODS: The protocol was registered on PROSPERO. A meta-analysis was conducted by searching 3 databases (PubMed, Scopus, CENTRAL) for relevant randomized controlled trials and observational studies. We included all studies published until November 2022 in any language. The primary outcome was the rate of bacterial infections, whereas the rate of shunt failure was our secondary endpoint. Odds ratios (OR) with 95% CI were calculated using a random-effects model. RESULTS: A total of 27 articles with 27 266 shunt operations were included in this study. The results indicated that using AISC is significantly associated with reduction in infections (OR = 0.42; 95% CI: 0.33-0.54). Regarding shunt failure, there was a tendency in favor of AISC use (OR = 0.73; 95% CI: 0.51-1.06). CONCLUSION: Our study provided evidence that AISC is significantly associated with the reduction in the rate of bacterial ventriculoperitoneal-shunt infection. In addition, there was a tendency toward AISC to decrease shunt failure compared with the standard shunt.
RESUMO
Central nervous system (CNS) tumours are the second most common neoplasm types in children. In most cases the aetiology is unknown, but some genetic syndromes can be related to CNS tumours. The symptoms are not specified, that is why in case of younger ages the tumour can reach extreme sizes. In case of infants the surgical technique is determined by the amount of circulating blood. Precise haemostasis is of utmost importance. In the last years, because of the development of imaging, surgical and anaesthetic techniques, the overall survival rate increased among paediatric brain cancer patients, and with this, the quality of life as well has improved significantly. Between 1975 and 2010 there was a 50% improvement in 5-year survival.
