Purpose

Myelomeningocele (MMC) is one of the commonest congenital malformations. Hydrocephalus develops in 65–85% of cases with MMC. Only 3–10% of MMC patients have normal urinary continence. We aim to investigate the effects of early and late operation in MMC patients in terms of development of hydrocephalus, motor deficits, and bladder functions.

Methods

Medical records of MMC patients operated between January 2008 and December 2014 were reviewed retrospectively.

Results

We retrospectively investigated patients’ records of 43 patients. Twenty of the patients were operated within the first 48 h after the delivery (early repair group), while 23 of the patients were operated after 48 h of delivery (late repair group). In the early repair group, 15 patients were operated due to hydrocephalus. Urodynamic problems were detected in 17 (85%) patients. In the late repair group, shunts were placed in 14 (61%) patients during follow-up period and urodynamic problems were detected in 19 (82.6%) patients. Mean operation time for the late group was 4.6 months. There was no statistical difference between the early and late group in terms of neurological and urodynamic deficits. The mean follow-up period was 45.5 months.

Conclusion

In the literature, surgery in the first 48 h of life is recommended for MMC patients. There was no difference between the early- and late-operated groups by means of hydrocephalus, urodynamic functions, and motor deficits in our study. Late surgery of intact sacs may avoid complications related to surgery in the neonatal period.

中文翻译：

---

回顾性分析早期和晚期脑膜脊髓鞘瘤患者。

目的

脊髓膜腔积液（MMC）是最常见的先天性畸形之一。65-85％的MMC患者会出现脑积水。MMC患者中只有3–10％的尿失禁正常。我们旨在研究脑积水，运动功能障碍和膀胱功能的发展对MMC患者早期和晚期手术的影响。

方法

回顾性分析了2008年1月至2014年12月期间手术的MMC患者的病历。

结果

我们回顾性调查了43例患者的病历。20例患者在分娩后的前48小时内进行了手术（早期修复组），而23例患者在分娩后48小时后进行了手术（后期修复组）。在早期修复组中，有15例因脑积水而手术。在17（85％）位患者中发现了尿动力学问题。在后期修复组中，在随访期间对14例（61％）患者进行了分流，并在19例（82.6％）患者中发现了尿动力学问题。晚期组的平均手术时间为4.6个月。早期组和晚期组在神经功能和尿动力学的缺陷方面无统计学差异。平均随访期为45.5个月。

结论

在文献中，MMC患者建议在生命的头48小时内进行手术。在我们的研究中，早期组和晚期组在脑积水，尿动力学功能和运动功能障碍方面无差异。完整囊的晚期手术可避免与新生儿期手术相关的并发症。