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  1. Home
  3. Role Of Endoscopic Third Ventriculostomy In Children In A High-burden Resource-limited Setting: A Prospective Study.
  1. Home
  3. Role Of Endoscopic Third Ventriculostomy In Children In A High-burden Resource-limited Setting: A Prospective Study.

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Role of endoscopic third ventriculostomy in children in a high-burden resource-limited setting: A prospective study.

Vaibhav Pandey1, Anutosh Singh2, Ruchira Nandan3

  • 1Department of Pediatric Surgery, IMS-BHU, Varanasi, Uttar Pradesh 221005, India.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|November 2, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Endoscopic third ventriculostomy (ETV) offers effective shunt-free survival for pediatric hydrocephalus, comparable to international outcomes. Younger age and CSF leaks predict failure, necessitating careful patient selection and technique.

Keywords:
Cerebrospinal fluidEndoscopic third ventriculostomyHydrocephalusPediatric neurosurgeryVentriculoperitoneal shuntcine MRI

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Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Hydrocephalus Management

Background:

  • Endoscopic third ventriculostomy (ETV) is an alternative to ventriculoperitoneal shunting for pediatric hydrocephalus.
  • ETV success rates in young children are variable, especially in resource-limited settings.

Purpose of the Study:

  • To evaluate the efficacy and safety of ETV in infants and young children (3-60 months) with hydrocephalus.
  • To identify predictors of ETV failure in this pediatric population.

Main Methods:

  • Prospective observational study of 96 children (3-60 months) undergoing ETV at a tertiary pediatric surgical center in India.
  • Analysis of demographics, etiology, intraoperative findings, complications, and 6-month and long-term outcomes (shunt-free survival).

Main Results:

  • 72.0% of 82 evaluable patients achieved 6-month ETV success.
  • Age < 6 months (54.5% success) and postoperative CSF leak (16.7% incidence, 62.5% requiring shunting) were associated with lower success rates.
  • Long-term shunt-free survival plateaued at approximately 74.3% through 5 years.

Conclusions:

  • ETV is an effective and durable treatment for hydrocephalus in young children, with outcomes comparable to international data.
  • Age under 6 months and postoperative CSF leak are significant predictors of ETV failure.
  • Optimizing ETV success in resource-constrained settings requires careful patient selection, meticulous surgical technique, and structured follow-up.