Endoscopic third ventriculostomy in previously shunted children: a retrospective study

Marton, Elisabetta; Feletti, Alberto; Basaldella, Luca; Longatti, Pierluigi

doi:10.1007/s00381-010-1130-1

Cited by 48 publications

(45 citation statements)

References 23 publications

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“…This definition is supported by Bilginer et al [86] and Marton et al [87]. In our series we also observed that 28 of the 34 patients with previous VPSs were children.…”

Section: Discussionsupporting

confidence: 89%

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Salvador

Oliveira

Pereira

et al. 2014

Clinical Neurology and Neurosurgery

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a b s t r a c tBackground: Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus, but the outcome is still controversial in terms of age and aetiology. Methods: Between 1998 and 2011, 168 consecutive procedures were performed in 164 patients, primarily children (56% < 18 years of age and 35% < 2 years of age). The causes of obstructive hydrocephalus included tumoural pathology, Chiari malformation, congenital obstruction of the aqueduct, post-infectious and post-haemorrhagic membranes, and ventriculo-peritoneal shunt (VPS) malfunctions. Successful ETV was defined by the resolution of symptoms and the avoidance of a shunt. Results: ETV was successful in 75.6% of patients, but 19% of the patients required VPS in the first month after ETV, and 5.4% required a VPS more than one month after ETV. Four patients were ultimately submitted for second ETVs. In this series, no major permanent morbidity or mortality was observed. Conclusions: ETV is a safe procedure and an effective treatment for obstructive hydrocephalus even following the dysfunction of previous VPSs and in children younger than two years.

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“…This definition is supported by Bilginer et al [86] and Marton et al [87]. In our series we also observed that 28 of the 34 patients with previous VPSs were children.…”

Section: Discussionsupporting

confidence: 89%

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Salvador

Oliveira

Pereira

et al. 2014

Clinical Neurology and Neurosurgery

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“…Patient age and the etiology of hydrocephalus have been reported to be associated with outcomes after ETV 4,5,7,20,22,23,25,26,30) . Interestingly, the results are different when ETV is performed after shunt failure (secondary ETV) than when ETV is performed as an initial treatment modality for hydrocephalus (primary ETV).…”

mentioning

confidence: 99%

“…Primary and secondary ETV outcomes for post-hemorrhagic hydrocephalus are 27% and 71%, respectively, and for post-meningitic hydrocephalus they are 0% and 75%, respectively 23) . Recently, Marton et al 22) reported outcomes of secondary ETV in pediatric patients and described a post-operative protocol. In this paper, we present our data from a retrospective study of secondary ETV, and we propose a simple and reasonable post-operative protocol that can detect ETV failure.…”

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confidence: 99%

Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

Lee

Kong

Seol

et al. 2011

J Korean Neurosurg Soc

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Objective : This paper presents data from a retrospective study of endoscopic third ventriculostomy (ETV) in patients with shunt malfunction and proposes a simple and reasonable post-operative protocol that can detect ETV failure. Methods : We enrolled 19 consecutive hydrocephalus patients (11 male and 8 female) who were treated with ETV between April 2001 and July 2010 after failure of previously placed shunts. We evaluated for correlations between the success rate of ETV and the following parameters : age at the time of surgery, etiology of hydrocephalus, number of shunt revisions, interval between the initial diagnosis of hydrocephalus or the last shunt placement and ETV, and the indwelling time of external ventricular drainage. Results : At the time of ETV after shunt failure, 14 of the 19 patients were in the pediatric age group and 5 were adults, with ages ranging from 14 months to 42 years (median age, 12 years). The patients had initially been diagnosed with hydrocephalus between the ages of 1 month 24 days and 32 years (median age, 6 years 3 months). The etiology of hydrocephalus was neoplasm in 7 patients; infection in 5; malformation, such as aqueductal stenosis or megacisterna magna in 3; trauma in 1; and unknown in 3. The overall success rate during the median follow-up duration of 1.4 years (9 days to 8.7 years) after secondary ETV was 68.4%. None of the possible contributing factors for successful ETV, including age (p=0.97) and the etiology of hydrocephalus (p=0.79), were statistically correlated with outcomes in our series. Conclusion : The use of ETV in patients with shunt malfunction resulted in shunt independence in 68.4% of cases. Age, etiology of hydrocephalus, and other contributing factors were not statistically correlated with ETV success. External ventricular drainage management during the immediate post-ETV period is a good means of detecting ETV failure.

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“…Marton et al concluded that "ETV secondary to shunt malfunction in pediatric patients has a success rate of 64%. As it is a safe and rapid treatment option even in emergency conditions, it is worth performing this procedure in previously shunted children [1]." Indeed, a similar report on the success rate of ETV was recently reported by O'Brien et al [2].…”

mentioning

confidence: 70%

“…

Dear EditorEditor, I read the recent publication on endoscopic third ventriculostomy (EVT) by Marton et al with a great interest [1]. Marton et al concluded that "ETV secondary to shunt malfunction in pediatric patients has a success rate of 64%.

…”

mentioning

confidence: 99%

Endoscopic third ventriculostomy

Wiwanitkit

2010

Childs Nerv Syst

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Dear EditorEditor, I read the recent publication on endoscopic third ventriculostomy (EVT) by Marton et al. with a great interest [1]. Marton et al. concluded that "ETV secondary to shunt malfunction in pediatric patients has a success rate of 64%. As it is a safe and rapid treatment option even in emergency conditions, it is worth performing this procedure in previously shunted children [1]." Indeed, a similar report on the success rate of ETV was recently reported by O'Brien et al. [2]. I have some additional concerns on this report. As a retrospective report, the result might be deviated due to uncontrolled bias. The success rate in this work is not high and this might be a problem for selecting ETV as the first choice for management of the patients, especially in emergency condition. It is also questionable whether EVT is a rapid option. There should be supportive evidence to support this conclusion. Also, there should be more information on the cost effectiveness of EVT compared to other options.

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Endoscopic third ventriculostomy in previously shunted children: a retrospective study

Abstract: In our experience, ETV secondary to shunt malfunction in pediatric patients has a success rate of 64%. As it is a safe and rapid treatment option even in emergency conditions, it is worth performing this procedure in previously shunted children.

Cited by 48 publications

References 23 publications

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

Endoscopic third ventriculostomy

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