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Endoscopic Third Ventriculostomy in Failed Ventriculoperitoneal Shunt in Pediatric Population
Ajay Choudhary1, Shivender Sobti2, Sourabh Zambre3
1Department of Neurosurgery, ABVIMS and Dr. RML Hospital, New Delhi, India.
Asian Journal of Neurosurgery
|March 12, 2021
Summary
Endoscopic third ventriculostomy (ETV) is an effective alternative treatment for pediatric hydrocephalus, especially after ventriculoperitoneal (VP) shunt failure. This procedure offers a viable option for children, regardless of age, who have experienced multiple shunt malfunctions.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Neurology
Background:
- Ventriculoperitoneal (VP) shunts are common for pediatric hydrocephalus but have high complication and revision rates.
- Endoscopic third ventriculostomy (ETV) presents a potential alternative to mitigate these VP shunt-related issues.
Purpose of the Study:
- To evaluate the efficacy of ETV as an alternative treatment for pediatric hydrocephalus following VP shunt failure.
- To determine factors influencing ETV success in pediatric patients with hydrocephalus.
Main Methods:
- Retrospective review of 36 pediatric patients with failed VP shunts treated with ETV between November 2010 and January 2016.
- Patients were categorized by age (<1, 1-10, 10-18 years), hydrocephalus type, and prior shunt revision history.
- Success was assessed based on clinical outcomes with a minimum 3-month follow-up.
Main Results:
- ETV demonstrated higher success rates in non-communicating hydrocephalus (84.2%) compared to communicating hydrocephalus (52.9%).
- Patients with two or more prior shunt malfunctions had a higher ETV success rate (86.7%) than those with only one malfunction (57.1%).
- Age and sex were not significant factors in ETV success.
Conclusions:
- Endoscopic third ventriculostomy (ETV) is an effective alternative treatment for pediatric hydrocephalus, particularly in cases of VP shunt failure.
- Patient age is not a contraindication for considering ETV in this population.
