Abstract：
BACKGROUND: Some centers utilize ventriculopleural shunt (VPLS) for treating hydrocephalus when conventional approaches are not feasible. Nonetheless, the literature regarding this approach is scarce.
OBJECTIVE: Evaluate the outcomes of VPLS through a single-arm meta-analysis.
METHODS: Following PRISMA guidelines, the authors systematically searched for articles utilizing the VPLS in a cohort with more than four patients. Outcomes included: mortality, pleural effusion, number of patients who underwent revisions, obstructions, shunt migration, emphysema, and subdural hematoma.
RESULTS: A total of 404 articles were reviewed, resulting in the inclusion of 13 retrospective studies encompassing 543 patients, with the majority being children (62.6 %). The median average follow-up period was 35.4 months (10-64.1). After analysis, results yielded a revision rate of 54 % (95 % CI: 44 %-64 %; I2=73 %). The most common complication observed was pleural effusion, with a post-analysis incidence of 16 % (95 % CI: 11 %-21 %; I2=63 %), followed by infections at 7 % (95 % CI: 4 %-10 %; I2=33 %). Shunt obstruction occurred in 13 % (95 % CI: 4 %-21 %; I2=84 %) of cases after analysis, while migrations, overdrainage, subdural hematoma, and cutaneous emphysema had minimal occurrence rates (0 %, 95 % CI: 0 %-1 %; I2=0 %). Notably, there were no reported cases of shunt-related mortality.
CONCLUSIONS: VPLS can be considered when there are no other suitable options for placing the distal catheter. However, the notable rates of shunt revisions, pleural effusion, infections, and the inherent heterogeneity of outcomes currently limit the widespread adoption of VPLS. In this scenario, other alternatives should be given priority.
OBJECTIVE: Evaluate the outcomes of VPLS through a single-arm meta-analysis.
METHODS: Following PRISMA guidelines, the authors systematically searched for articles utilizing the VPLS in a cohort with more than four patients. Outcomes included: mortality, pleural effusion, number of patients who underwent revisions, obstructions, shunt migration, emphysema, and subdural hematoma.
RESULTS: A total of 404 articles were reviewed, resulting in the inclusion of 13 retrospective studies encompassing 543 patients, with the majority being children (62.6 %). The median average follow-up period was 35.4 months (10-64.1). After analysis, results yielded a revision rate of 54 % (95 % CI: 44 %-64 %; I2=73 %). The most common complication observed was pleural effusion, with a post-analysis incidence of 16 % (95 % CI: 11 %-21 %; I2=63 %), followed by infections at 7 % (95 % CI: 4 %-10 %; I2=33 %). Shunt obstruction occurred in 13 % (95 % CI: 4 %-21 %; I2=84 %) of cases after analysis, while migrations, overdrainage, subdural hematoma, and cutaneous emphysema had minimal occurrence rates (0 %, 95 % CI: 0 %-1 %; I2=0 %). Notably, there were no reported cases of shunt-related mortality.
CONCLUSIONS: VPLS can be considered when there are no other suitable options for placing the distal catheter. However, the notable rates of shunt revisions, pleural effusion, infections, and the inherent heterogeneity of outcomes currently limit the widespread adoption of VPLS. In this scenario, other alternatives should be given priority.
摘要：
背景：当常规方法不可行时，一些中心利用脑室胸膜分流术（VPLS）治疗脑积水。尽管如此，关于这种方法的文献很少。
目的：通过单臂荟萃分析评估VPLS的结局。
方法：遵循PRISMA指南，作者在超过4名患者的队列中系统地检索了利用VPLS的文章.结果包括：死亡率，胸腔积液,接受翻修的患者数量，障碍物,分流迁移，肺气肿,和硬膜下血肿.
结果：共审查了404篇文章，结果纳入了13项回顾性研究，包括543名患者，大多数是儿童(62.6%)。中位平均随访时间为35.4个月(10-64.1)。经过分析,结果的修订率为54%(95%CI:44%-64%;I2=73%).最常见的并发症是胸腔积液，分析后发生率为16%（95%CI：11%-21%；I2=63%），其次是7%的感染（95%CI：4%-10%；I2=33%）。13％（95％CI：4％-21％；I2=84％）的病例发生分流梗阻。在迁移的同时，过排水,硬膜下血肿,皮肤气肿的发生率最低(0%，95%CI：0%-1%；I2=0%）。值得注意的是,没有分流相关死亡病例的报告.
结论：当没有其他合适的选择放置远端导管时，可以考虑使用VPLS。然而,显著的分流修正率，胸腔积液,感染,结果的固有异质性目前限制了VPLS的广泛采用。在这种情况下，其他替代方案应优先考虑。
目的：通过单臂荟萃分析评估VPLS的结局。
方法：遵循PRISMA指南，作者在超过4名患者的队列中系统地检索了利用VPLS的文章.结果包括：死亡率，胸腔积液,接受翻修的患者数量，障碍物,分流迁移，肺气肿,和硬膜下血肿.
结果：共审查了404篇文章，结果纳入了13项回顾性研究，包括543名患者，大多数是儿童(62.6%)。中位平均随访时间为35.4个月(10-64.1)。经过分析,结果的修订率为54%(95%CI:44%-64%;I2=73%).最常见的并发症是胸腔积液，分析后发生率为16%（95%CI：11%-21%；I2=63%），其次是7%的感染（95%CI：4%-10%；I2=33%）。13％（95％CI：4％-21％；I2=84％）的病例发生分流梗阻。在迁移的同时，过排水,硬膜下血肿,皮肤气肿的发生率最低(0%，95%CI：0%-1%；I2=0%）。值得注意的是,没有分流相关死亡病例的报告.
结论：当没有其他合适的选择放置远端导管时，可以考虑使用VPLS。然而,显著的分流修正率，胸腔积液,感染,结果的固有异质性目前限制了VPLS的广泛采用。在这种情况下，其他替代方案应优先考虑。
