The Comparison Between Lumboperitoneal Shunt And Ventriculoperitoneal Shunt For Normal Pressure Hydrocephalus -Meta Analysis

Object:Ventriculoperitoneal shunt(VPS)is the most commonly used treatment for normal-pressure hydrocephalus(NPH),which is a common neurosurgical disease.Some researches hold that lumboperitoneal shunt(LPS)has equivalent efficacy as VPS,thus suggesting the application of LPS to normal-pressure hydrocephalus.In this study,we compared the efficacy of LPS and VPS on normal-pressure hydrocephalus and their complications.Methods:We did a systematic review of articles published up until November,2016,by searching PubMed,EMbase,Cochrane Central Register of Controlled Trials and references of related literatures.Two reviewers screened the literature independently,and after data were extracted,the meta-analysis was conducted with the use of RevMan5.3.Results:Eight primary studies meeting our inclusion criteria were included in this meta-analysis,involving 892 patients,and results showed:data pooled by random effects model revealed that the difference in clinical efficacy between two groups had no statistical significance(OR=0.51,95%CI=0.62-2.90,p=0.23),while data pooled by fixed effects model revealed that LPS had a poorer efficacy than VPS(OR=0.59,95%CI=0.39-0.88,p=0.009),with a larger heterogeneity(?~2=76%).The complication rate of LPS was lower than that of VPS,and the difference had a statistical significance(OR=0.31,95%CI=0.20-0.46,p<0.00001).Conclusion:It is uncertain to identify LPS has the equivalent efficacy as VPS does;but the complication rate of LPS may be lower than that of VPS.Therefore,it is necessary to carry out prospective and high quality researches to compare the efficacy of LPS and VPS,and their complication rates.