Surgical Outcomes of Third Ventriculostomy in Patients of Obstructive Hydrocephalus (original) (raw)
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Frequency and Pattern of Early Complications After Ventriculostomy in Obstructive Hydrocephalus
2020
Introduction: Endoscopic techniques are being increasingly used in the management of various neurosurgical pathologies, in recent times. Objectives: The main objective of the study is to analyse the frequency and pattern of early complications after ventriculostomy in obstructive hydrocephalus. Material and methods: This retrospective study was conducted in Punjab Health Department during 2019 to 2020. Detailed history, examination and baseline investigations, including imaging; such as CT Scan in all patients, while MRI brain in those patients, who could afford were done. All the demographics were recorded on a predesigned proforma including name, age, gender and address. Results: ETV was done in eight cases only of obstructive hydrocephalus due to congenital aqueductal stenosis that were fulfilling the highly selective inclusion criteria out of 150 patients with obstructive hydrocephalus managed in our hospital, their age was ranging from one to six months with no apparent history of previous CNS infection or septicemia as a primary treatment for their disease. Conclusion: It is concluded that Endoscopic third ventriculostomy can be considered as a treatment modality of choice for obstructive hydrocephalus. Postoperative complications were minimal with only 1% mortality rate in our series.
Pakistan Journal Of Neurological Surgery, 2020
Objective: To determine the frequency, pattern and outcome of early complications after endoscopic third ventriculostomy (ETV) in Obstructive hydrocephalus. Material and Methods: The study included 160 patients from Neurosurgery department, Lady Reading Hospital Peshawar and private clinics over a period of twelve months. After performing ETV under general anesthesia by a single expert neurosurgeon, the patients were followed up for seven days post operatively for the CSF leak, wound infection, meningitis, seizures, bleeding and in hospital death. Results: Eighty five percent of the patients had no untoward complications, while 15% showed complications including CSF leak (5%), wound infection (3%), meningitis (2%), seizures (2%), bleeding (2%) and in hospital death (1%). Conclusion: Due to the less invasive nature, endoscopic third ventriculostomy is favored for treating obstructive hydrocephalus in select patient population as it is safe and have better outcomes.
Surgical Neurology International, 2021
Background: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative to shunts in surgical treatment of obstructive hydrocephalus. Long-term failure, age limitations, and outcome by cause are some of the issues debated in literature. The objective of this article is to analyze the clinical success and failure of ETV and its main complications. Methods: A total of 209 patients with hydrocephalus were submitted to ETV, including a mixed population of children and adults (from 0 to 59 years). Patients were divided into five groups: A – tumors, B – aqueductal stenosis, C – myelomeningocele, D – infection and hemorrhage, and E – arachnoid cyst. Variables were analyzed: age, ETV success rate, cerebrospinal fluid (CSF) fistula, mortality, and complications. Results: The two main causes of hydrocephalus were tumors (44.9%) and aqueductal stenosis (25.3%). The overall success rate was of 82.8%, and patients in Group E had the highest rate 90.9%. Group A had a succ...
Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: Success and failure
The Professional Medical Journal
Objective: To determine if endoscopic third ventriculostomy (ETV) is effective in the treatment of obstructive hydrocephalus. Study Design: Prospective study. Setting: Department of Neurosurgery, Hayatabad Medical Complex, Peshawar. Period: February 2018 to March 2021. Material & Methods: Eighty Five patients underwent endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus all patients with obstructive hydrocephalus of any gender and age more than 6 months were included in the study. Patients age less than 6 months, recurrent cases and those refuse to opt for ETV were excluded from our study. The information regarding patient demographic, etiology, complications of procedure were documented in proforma. Data was analyzed using SPSS version 20.0 and presented in form of tables. Results: In the current study out of 85 patients, 48(56.4%) were male and 37(43.5%) were females with male to female ratio=1.23. ETV had successful outcome in 66(77.6%) patients. The sign and s...
Clinical neurology and neurosurgery, 2014
Background: 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.
Asian journal of neurosurgery
Management of obstructive hydrocephalus is an important issue for the reduction of mortality and morbidity. The aim of the present study was to assess the early surgical outcome of endoscopic third ventriculostomy (ETV) in the management of obstructive hydrocephalus. This randomized controlled trial was conducted at the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from April 2009 to September 2010 for 1½ years. All patients presenting with obstructive hydrocephalus with the obstruction at or distal to the third ventricle and age 6 months and above were included in the study population. All the patients were divided into two groups named as Group A (experimental group) who were treated with ETV and Group B (control group) who were treated with ventriculoperitoneal shunt (VPS). The early surgical outcome was defined as outcomes within 1 month following surgical interventions. Pre- and post-operative outcomes of this study were measured....
Endoscopic Third Ventriculostomy for Treatment of Obstructive Hydrocephalus
2000
Background: Endoscopic third ventriculostomy has become the preferred treatment for obstructive hydrocephalus. The purpose of this paper is to present our experience with ventriculostomy at our center. Methods: Twenty-four patients underwent ventriculostomy for the treatment of obstructive hydrocephalus between May 2000 and May 2006. The follow-up period lasted between one and 51 (median: four) months. The mean age of the
Endoscopic Third Ventriculostomy in Cases of Hydrocephalus: An Institutional Experience
Indian Journal of Neurosurgery
Background With the recent advances in optical and mechanical instrumentation, endoscopic third ventriculostomy (ETV) has emerged as the procedure of choice for the treatment of hydrocephalus in selected patients. Objective: To study the role of ETV in therapeutic management of hydrocephalus in a tertiary care center. Materials and Methods The present study was conducted in the Department of Neurosurgery at Dr. Ram Manohar Lohia Hospital. Endoscopic third ventriculostomy was performed as a therapeutic procedure in patients diagnosed with hydrocephalus requiring surgical intervention and admitted from June 2017 to July 2018. ETV success was defined by resolution or improvement in clinical symptoms and ETV failure was considered in patients whose symptoms either deteriorated or did not improve from the baseline and required ventriculoperitoneal shunt. Results A total of 85 patients were included in this study who underwent the therapeutic ETV. In the present study, the overall ETV suc...
Surgical Neurology, 2008
Background: The clinical response to ETV of adult patients with noncommunicating hydrocephalus may differ from that of children because of such factors as chronicity of hydrocephalus, physiologic differences in CSF dynamics, and changes in brain viscoelastic properties. We sought to determine which factors might predict clinical success and failure. Methods: A retrospective single-surgeon case series analysis was performed. This was a consecutive case series for which the goal of the ETV procedures was shunt independence. One hundred ten ETV procedures were performed in 108 adult patients (mean, 48 years; range, 17-88 years). There were 52 cases of idiopathic aqueductal stenosis, 47 cases of mass lesions causing noncommunicating hydrocephalus, plus 9 other miscellaneous obstructive etiologies. Results: Long-term shunt independence was achieved in 77% of patients. Two additional patients, who initially failed, later achieved success after reoperation and remained shunt free for the duration of their follow-up. Therefore, after reoperation, shunt independence was achieved in 79% of patients. Of the patients who ultimately failed, 11 failed within 1 month. Therefore, 52% who ultimately failed had more than 1 month of shunt-free existence (mean, 10 months). There were 6 surgical complications, including 2 deaths related to intracranial hemorrhage from brain tumors (not directly related to ETV per se), and 10 medical complications. The median hospital length-of-stay was 3 days. The median follow-up was 8 months (range, 0-95 months). Conclusions: Endoscopic third ventriculostomy is an effective treatment option for adult patients with noncommunicating hydrocephalus. Although most procedures resulted in long-term shunt independence, more than half of the eventual failures were delayed, and therefore, appropriate follow-up is required.