Valveless shunting in occlusive hydrocephalus in children

Operations were carried out on 32 children for the occlusive form of hydrocephalus with impaired resorption of the cerebrospinal fluid. Thirty children were under the age of 12 months, two were up to 2 years of age. Twenty-seven patients underwent two interventions either in one stage or at an interval of up to 4 months: ventriculocisternostomy (VC) and lumboperitoneal anastomosis by means of an avalvular shunt; five children were subjected only to VC. Hydrocephalus was stabilized in 18 children (85.7%) by the combined intervention and in 1 (20%) by means of VC alone. One-stage performance of Torkildsen's operation with lumboperitoneal anastomosis produces results, which are more reliable and fewer complications. These two operations can be conducted separately at some interval only if the child is very weak in the preoperative period and vital disorders occur during the surgical intervention. The performance of VC without subsequent lumboperitoneal anastomosis is a great risk for infants and young children. The developed techniques of one-stage VC with lumboperitoneal anastomosis and the use of avalvular drains is simple and reliable, which allows it to be recommended for wide use in neurosurgical practice.