{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:58:47Z","timestamp":1793447927934,"version":"4.5.0"},"reference-count":26,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"West China Hospital of Sichuan University","award":["141191462"],"award-info":[{"award-number":["141191462"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,8,17]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Ventriculoperitoneal shunt (VPS) remains the most widely used methods to treat communicating hydrocephalus. More recently, lumboperitoneal shunt (LPS) has been suggested as a reasonable option in some studies. However, there is lack of high-quality studies comparing these two techniques in order to certain the benefits and harms to use one of these two methods. The purpose of the current study is to determine the effectiveness and safety of the LPS versus the VPS in patients with communicating hydrocephalus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>All eligible patients aged 18\u201390 years with communicating hydrocephalus will be recruited and then randomly allocated into LPS or VPS group in a ratio of 1:1. All patients will be analysed before shunt insertion, at the time of discharge, 1\u2009month, 6 months, 12 months and 24 months postoperatively. The primary outcome measure is the rate of shunt failure at a 2-year follow-up term. The secondary outcomes include Keifer\u2019s Hydrocephalus Scale, National Institute of Health Stroke Scale, Glasgow Outcome Scale Extended, Evans index, safety endpoints and cost-effectiveness of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The study will be performed in compliance with the Declaration of Helsinki (2002) of the World Medical Association. The study was approved by Institutional Review Board of West China Hospital. All patients will be fully informed the potential benefits, potential risks and responsibilities, those who will sign the informed consents once they are included. Preliminary and final results will be published in peer-reviewed journals and presented at national and international congresses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ChiCTR2100043839.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2021-051127","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T16:54:36Z","timestamp":1629996876000},"page":"e051127","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Shunting outcomes in communicating hydrocephalus: protocol for a multicentre, open-label, randomised controlled trial"],"prefix":"10.1136","volume":"11","author":[{"given":"Tong","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyao","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingguo","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yikai","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuepei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yicheng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4028-797X","authenticated-orcid":false,"given":"Junwen","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"2024112509094859000_11.8.e051127.1","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1007\/s10072-016-2589-7","article-title":"New concept of the pathogenesis and therapeutic orientation of acquired communicating hydrocephalus","volume":"37","author":"Xu","year":"2016","journal-title":"Neurol Sci"},{"key":"2024112509094859000_11.8.e051127.2","first-page":"39","volume-title":"Handbook of clinical neurology","volume":"145","author":"Leinonen","year":"2018"},{"key":"2024112509094859000_11.8.e051127.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2012.06.004"},{"key":"2024112509094859000_11.8.e051127.4","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/S0140-6736(15)60694-8","article-title":"Hydrocephalus in children","volume":"387","author":"Kahle","year":"2016","journal-title":"The Lancet"},{"key":"2024112509094859000_11.8.e051127.5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3171\/2017.1.PEDS16496","article-title":"Shunting outcomes in posthemorrhagic hydrocephalus: results of a hydrocephalus clinical research network prospective cohort study","volume":"20","author":"Wellons","year":"2017","journal-title":"J Neurosurg Pediatr"},{"key":"2024112509094859000_11.8.e051127.6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11940-019-0604-z","article-title":"Current update on treatment strategies for idiopathic normal pressure hydrocephalus","volume":"21","author":"Isaacs","year":"2019","journal-title":"Curr Treat Options Neurol"},{"key":"2024112509094859000_11.8.e051127.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2013.01.096"},{"key":"2024112509094859000_11.8.e051127.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2021.106049"},{"key":"2024112509094859000_11.8.e051127.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0196216","article-title":"Fsi simulation of CSF hydrodynamic changes in a large population of non-communicating hydrocephalus patients during treatment process with regard to their clinical symptoms","volume":"13","author":"Gholampour","year":"2018","journal-title":"PLoS One"},{"key":"2024112509094859000_11.8.e051127.10","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e318285b37c"},{"key":"2024112509094859000_11.8.e051127.11","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00046-0"},{"key":"2024112509094859000_11.8.e051127.12","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1007\/s00701-018-3654-1","article-title":"One-Year outcome of patients with posttraumatic hydrocephalus treated by lumboperitoneal shunt: an observational study from China","volume":"160","author":"Sun","year":"2018","journal-title":"Acta Neurochir"},{"key":"2024112509094859000_11.8.e051127.13","doi-asserted-by":"crossref","first-page":"e308","DOI":"10.1016\/j.wneu.2018.06.021","article-title":"Establishing a preoperative evaluation system for Lumboperitoneal shunt: approach to attenuate the risk of shunt failure","volume":"117","author":"Sun","year":"2018","journal-title":"World Neurosurg"},{"key":"2024112509094859000_11.8.e051127.14","doi-asserted-by":"crossref","first-page":"e638","DOI":"10.1016\/j.wneu.2019.03.235","article-title":"Lumboperitoneal and ventriculoperitoneal shunt surgery for posthemorrhagic communicating hydrocephalus: a comparison","volume":"127","author":"Wang","year":"2019","journal-title":"World Neurosurg"},{"key":"2024112509094859000_11.8.e051127.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.01.072"},{"key":"2024112509094859000_11.8.e051127.16","doi-asserted-by":"crossref","first-page":"e956","DOI":"10.1016\/j.wneu.2019.06.070","article-title":"Efficacy and safety of Lumboperitoneal shunt in the treatment of all-cause communicating hydrocephalus: analysis of risk factors of shunt failure","volume":"132","author":"Sun","year":"2019","journal-title":"World Neurosurg"},{"key":"2024112509094859000_11.8.e051127.17","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1227\/01.NEU.0000255469.68129.81","article-title":"Complications of lumboperitoneal shunts","volume":"60","author":"Wang","year":"2007","journal-title":"Neurosurgery"},{"key":"2024112509094859000_11.8.e051127.18","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.3171\/2015.10.JNS151894","article-title":"One-year outcome in patients with idiopathic normal-pressure hydrocephalus: comparison of lumboperitoneal shunt to ventriculoperitoneal shunt","volume":"125","author":"Miyajima","year":"2016","journal-title":"J Neurosurg"},{"key":"2024112509094859000_11.8.e051127.19","doi-asserted-by":"publisher","DOI":"10.3171\/2018.5.JNS1875"},{"key":"2024112509094859000_11.8.e051127.20","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-3-201302050-00583"},{"key":"2024112509094859000_11.8.e051127.21","first-page":"1","article-title":"Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis","author":"Giordan","year":"2018","journal-title":"J Neurosurg"},{"key":"2024112509094859000_11.8.e051127.22","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1093\/ons\/opy044","article-title":"Lumboperitoneal shunts for the treatment of idiopathic normal pressure hydrocephalus: a comparison of Small-Lumen abdominal catheters to gravitational add-on valves in a single center","volume":"15","author":"Nakajima","year":"2018","journal-title":"Oper Neurosurg"},{"key":"2024112509094859000_11.8.e051127.23","doi-asserted-by":"crossref","first-page":"632","DOI":"10.3171\/2018.6.PEDS17642","article-title":"The role of lumboperitoneal shunts in managing chronic hydrocephalus with slit ventricles","volume":"22","author":"Marupudi","year":"2018","journal-title":"J Neurosurg Pediatr"},{"key":"2024112509094859000_11.8.e051127.24","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.surneu.2003.05.003","article-title":"Evaluation of the Miethke dual- switch valve in patients with normal pressure hydrocephalus","volume":"61","author":"Meier","year":"2004","journal-title":"Surg Neurol"},{"key":"2024112509094859000_11.8.e051127.25","doi-asserted-by":"crossref","first-page":"S2-4","DOI":"10.1227\/01.NEU.0000168185.29659.C5","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin","year":"2005","journal-title":"Neurosurgery"},{"key":"2024112509094859000_11.8.e051127.26","doi-asserted-by":"crossref","first-page":"775","DOI":"10.2176\/nmc.52.775","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus: second edition","volume":"52","author":"Mori","year":"2012","journal-title":"Neurol Med Chir"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-051127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T17:15:21Z","timestamp":1732554921000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-051127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":26,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,26]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bmjopen-2021-051127"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-051127","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}