Cranioplasty and Ventriculoperitoneal Shunt Placement after Decompressive Craniectomy: Staged Surgery Is Associated with Fewer XXXX .

@entity1 @entity260 @entity1276
OBJECTIVE: Decompressive craniectomy (DC) requires later cranioplasty (CP) in survivors. However, if additional ventriculoperitoneal shunt (VPS) placement due to shunt-dependent @entity1276 is necessary, the optimal timing of both procedures still remains controversial. We therefore analyzed our computerized database concerning the optimal timing of CP and @entity260 . METHODS: From 2009-2014, 41 cranioplasty procedures with simultaneous or staged VPS placement were performed at the authors' institution. @entity1 were stratified into two groups according to the time from CP to VPS ("simultaneous" and "staged"). @entity1 characteristics, timing of CP and VPS, as well as procedure-related complications, were assessed and analyzed. RESULTS: Overall CP and VPS were performed simultaneously in 41% and in staged fashion in 59% of the @entity1 . The overall complication rate was 27%. @entity1 who underwent simultaneous CP and VPS suffered significantly more often from complications compared with @entity1 who underwent staged CP and VPS procedures (47% vs. 12%; P = 0.03). @entity1 with simultaneous CP and VPS had a significantly higher rate of infectious postoperative complications compared with @entity1 with staged procedures (P = 0.003). On multivariate analysis, simultaneous CP and VPS procedure was the only significant predictor of postoperative complication after CP and VPS (P = 0.03). CONCLUSION: We provide detailed data on surgical timing and complications for cranioplasty and ventriculoperitoneal shunt placement after DC. The present data suggest that @entity1 who undergo staged CP and VPS procedures might benefit from a lower complication rate. This might influence future surgical decision making regarding optimal timing of CP and VPS placement.
