Endoscopic 3rd ventriculocisternostomy: procedural complications and long-term dysfunctions?

Area of Science:

• Neurosurgery
• Pediatric Neurosurgery
• Neurology

Background:

• Non-communicating hydrocephalus management often involves shunts.
• Endoscopic third ventriculostomy (ETV) is increasingly preferred for non-communicating hydrocephalus.
• Long-term outcomes and safety of ETV require continued evaluation.

Purpose of the Study:

• To assess the efficacy and long-term outcomes of ETV in non-communicating hydrocephalus.
• To evaluate the morbidity and mortality associated with ETV.
• To identify predictors of ETV success or failure.

Main Methods:

• Retrospective analysis of 82 patients with non-communicating hydrocephalus treated with ETV.
• Evaluation of clinical improvement, shunt independence, and ventricular size changes.
• Uni- and multivariate analyses to determine predictive factors for ETV dysfunction.

Main Results:

• Overall ETV success rates were 65.4% in pediatric and 83.9% in adult groups.
• Mean follow-up was approximately 50-60 months.
• Procedural complications occurred in 6.1% of patients, with no deaths; infectious etiology and age <16 predicted failure.

Conclusions:

• ETV is a safe and effective long-term treatment for non-communicating hydrocephalus.
• ETV should be considered a first-line therapy.
• Infectious meningitis and young age are associated with higher risks of ETV failure.