Factors Associated with Ventriculoperitoneal Shunt Placement Following Posterior Fossa Tumor Resection in Children: A Systematic Review and Meta-Analysis

Background and Objectives: Posterior fossa tumors (PFTs) are common pediatric brain tumors and frequently present with obstructive hydrocephalus. Although tumor resection restores cerebrospinal fluid (CSF) circulation in many patients, a subset subsequently requires ventriculoperitoneal shunt (VPS) placement. This systematic review and meta-analysis aimed to identify factors associated with postoperative VP shunt placement following PFT resection in children. Materials and Methods: This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was prospectively registered with PROSPERO (CRD420261455396). A comprehensive search of major electronic databases was conducted from inception to April 2025. Observational studies evaluating factors associated with postoperative VP Shunt placement in children undergoing PFT resection were included. Risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool, and certainty of evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for prognostic factor research. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects meta-analysis.