Frequency of success and complications of primary endoscopic third ventriculostomy in infants with obstructive hydrocephalous

Abstract

Objectives: To determine the success rate and complications of primary endoscopic third ventri-culostomy (ETV) in infants with obstructive hydrocephalous.
 Methods: This case series was conducted at the Department of Neurosurgery, Medical and Teaching Institute, Lady Reading Hospital Peshawar from July 2016 to June 2018. All consecutive patients with age less than one year who underwent ETV for primary obstructive hydrocephalous, of both gender, were included in the study. The patients were followed up to six months after surgery. The data was entered in a specially designed Performa. Patients’ data was analyzed using SPSS version 21.0.
 Results: We had total 21 patients with age less than one year during the study period. Male patients were 11 (52.4%). Success rate of ETV at six months of follow up was 12 (57.1%). Post-op complications observed were in 9.52% (2/21) cases. One patient had cerebrospinal fluid CSF) leak and the other had significant bleed.
 Conclusion: ETV is successful in 57.1% of infants with obstructive type of hydrocephalous. The post op complications in case of ETV are lower than Ventriculo-peritoneal shunts. Therefore, ETV can be offered to infants having obstructive hydrocephalous.
 doi: https://doi.org/10.12669/pjms.38.1.4097
 How to cite this:Sharafat S, Khan Z, Azam F, Ali M. Frequency of success and complications of primary endoscopic third ventriculostomy in infants with obstructive hydrocephalous. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4097
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Neuroendoscopic Techniques in the Treatment of Hydrocephalus

“…Although ETV is widely used in the treatment of hydrocephalus, its success rate is below 100%, and about 25 to 40% of patients undergoing ETV require further ventricular-peritoneal shunting [25,28,29]. In a study by Iantosca, after analyzing the relationship between the etiology of hydrocephalus and the prognosis of ETV [30], patients with hydrocephalus were divided into three groups according to surgical success rates.…”

“…Central nervous system infection: The latest statistics show that the incidence of central nervous system infection after ETV is 1.81%, including meningitis at 1.6% and ventriculitis at 0.21% [49]. However, varying overall rates of central nervous system infection have been reported, ranging from 1 to 6.1% [29,33,56]. Nevertheless, most scholars believe that neuroendoscopic treatment of hydrocephalus for central nervous system infection is closely related to a patient's previous history of shunt infection.…”

“…Fukuhara et al identified central nervous system infection as an independent risk factor for ETV failure [28,58,59]. Despite the occurrence of infection, the prognosis is significantly better than that of patients with infection after shunt surgery, and in most cases, the infection can be controlled with targeted medical therapy [28,29,59].…”