Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures.

Area of Science:

• Neurosurgery
• Neurology
• Pediatric Neurosurgery

Background:

• Occlusive hydrocephalus presents a significant neurosurgical challenge.
• Endoscopic third ventriculostomy (ETV) is an established alternative to shunting for hydrocephalus treatment.
• Optimal timing, indications, and techniques for ETV remain subjects of ongoing clinical discussion.

Purpose of the Study:

• To evaluate the efficacy and safety of ETV in a large cohort of patients with occlusive hydrocephalus.
• To identify patient subgroups and etiological factors associated with successful ETV outcomes.
• To analyze the complication profile and long-term effectiveness of ETV.

Main Methods:

• Retrospective analysis of 100 consecutive ETV procedures performed in 95 patients.
• Patient demographics, hydrocephalus etiology, and surgical techniques were recorded.
• Outcomes, including success rates and complications, were assessed.

Main Results:

• ETV was successfully completed in 98% of cases, with an overall success rate of 76%.
• Highest success rates were observed in patients with benign space-occupying lesions (95%) and aqueductal stenosis (83%).
• Complications were infrequent and included bleeding and infection, with no permanent morbidities or mortalities.

Conclusions:

• ETV is a highly effective treatment for uncomplicated occlusive hydrocephalus, especially when caused by aqueductal stenosis or space-occupying lesions.
• The procedure remains effective in approximately two-thirds of patients with a history of infection or intraventricular bleeding.
• ETV is recommended at the time of shunt failure in patients with occlusive hydrocephalus, potentially with shunt removal. Stereotactic guidance can aid in complex cases.