Should the ventricular tube be replaced when the ventricular drainage is changed to ventricular-abdominal shunt?

Ref:Soleman J,et al.Childs Nerv Syst.
 2017 Nov;33 (11): 1947-1952doi: 10.1007/s00381-017-3544-5Epub 2017 Jul 24Brain Outdoor Drainage (EVD) is a common surgical procedure for neurosurgery and is suitable for acute hydrocephalus or ventricular surgery for different causesSome patients may develop chronic hydrocephalus and require ventriculo-peritoneal shunt (ventriculo-peritoneal shunt, VPS)Many neurosurgeons believe that retaining the primary ventricle tube may cause infection, and recommendreting the re-entry of ventricular puncturetubes, but there are also advocates of not repeating ventricle punctures and replacing ventriclesJehuda Soleman of Children's Neurosurgery at Dena Children's Hospital, Tel Aviv Medical Center, Israel, and others conducted a long follow-up analysis of whether EVD changes to ventricular ventricular shunts need to replace the ventricle, published in the November 2017 issue of Childs Nerv Systthe study included 17 patients with 18 EVD-modified ventricular ventricle shunts between 2008 and 2017The operations are performed in a sterile operating room, and the EVD is placed in a 5-7cm-long subcutaneous tunnelAfter more than 56.5 months of follow-up found that the EVD to VP diversion time of 2 to 18 days, the average 9 to 3.6 days5 cases of shunt system infection, 1 early infection within 30 days after surgery, 1 infection in 9 months after surgery, 1 case after 9 days of shunt system disorder, 2 cases in 6.5 months and 9 years of shunt system disorder There were no other complications and no deaths related to shunts The authors believe that not replacing the ventricles will not cause increased infection rates and failure rates And summed up the following experience: 1 brain outdoor drainage must be carried out in a strictly sterile operating room, subcutaneous tunnel at least 5cm away from the incision, which is an effective means to prevent the risk of infection; Ventorricles can effectively reduce infection rates, 4 incisions should be as small as possible, and strengthen the management of the brain outdoor drainage tube, 5 If the length of the EVD subcutaneous tunnel is insufficient, the incision can be re-selected, 6EVD preoperative preventive application of antibiotics until one week after VP diversion the authors believe that the brain's outdoor drainage is changed to ventricular abdominal shunt, eliminating the need to replace the ventricle tube, which does not increase the risk of infection (Xu Wei, of Neurosurgery, Tongji Hospital, affiliated with Huazhong University of Science and Technology, compiled , Dr Huayu , of Huashan Hospital, affiliated with Fudan University, editor-in-chief of "Outside Information" and professor of Chen Jingcheng , affiliated with Fudan University, related links