Outcome Comparison of Endoscopic Third Ventriculostomy versus Ventriculoperitoneal Shunt in Obstructive Hydrocephalus

Abstract

Background and Objectives: To assess the outcome of Endoscopic Third Ventriculostomy (ETV) versus Ventriculoperitoneal Shunt (VPS) in Obstructive Hydrocephalus in terms of infections, foreign bodies, cost-effectiveness, and length of hospital stay.
 Materials and Methods: It was a Randomized Controlled Trial study, in which 30 patients with Obstructive Hydrocephalus were divided into two groups one was treated with (ETV) and the other was treated with VP Shunt and the patients were followed up for 1 year.
 Results: Patients were divided into 2 groups, 15 were treated with ETV, and 15 were treated with VP Shunt. Length of stay for VP shunt was 7 ± 0.85 days and for ETV mean stay was 2.93 ± 1.1 days. The complication was observed in 4 (26.7%) treated with VP Shunt and in 3 (20%) patients with Endoscopic Third Ventriculostomy. In ETV, 3 (20%) patients had recurrence whereas in VP shunt in 1 (6.67%) had an infection and in 3 (20%) patients had recurrence (upper-end blockage) and the overall success rate was 76% in both the procedures and in VP Shunt 73.3% and ETV 80%. Overall there were no complications found in 23 (76.6%) patients, in 3 (10%) patient’s complications were found at 1st month, in 3 (10%) complications were observed at 3rd month, and in 1(3.3%) complication was recorded at 6th month.
 Conclusion: ETV was found better in terms of length of hospital stay, cost-effectiveness as well as minimal complication rate as compared to VP shunt.

Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis

“…Moreover, in terms of postoperative complications, reported lower rates of infection, reoperation, and shorter hospital stays associated with ETV compared to VPS, aligning with the meta-analysis results indicating favorable outcomes with ETV in terms of postoperative complications [16].…”

Endoscopic Third Ventriculostomy in the Pediatric Patient

“…Despite the fact that the calculation of the Costs to compare TVE vs. VP shunt may vary from country to country, ETV represents less economic costs if it is taken into account that no device is left, and the number of surgeries per patient may be less in the patient who receives TVE; however, there are not enough relative studies to establish a significant difference, since various studies that have been carried out were carried out in countries with different economic incomes and did not show statistical significance in terms of costs [67] others compared and the VP shunt, endoscopic third ventriculostomy (ETV) was proven to be better in terms of infection, length of hospital stay, cost-effectiveness, and complication rate [68].…”