BACKGROUND: Endoscopic third ventriculostomy (ETV) has gained wide popularity as a first-line treatment for obstructive hydrocephalus (OHC). We have been performing ETV since 1998. We report our experience with this technique in the management of OHC. METHODS: Between 1998 and 2007, we performed 49 ETV procedures in 46 patients suffering from OHC. Medical records were retrospectively reviewed. Success was defined as shunt-free survival. RESULTS: There were 29 males and 17 females with a mean age of 23 years (6 months-65 years). Aqueductal stenosis and tectal tumor were the most common etiologies (63%). Seven patients (15.6%) had early ETV failure. Of 38 patients with initial success and available follow-up, shunt independence was achieved in 29 patients (76.3%) after a mean follow-up of 37 months. Kaplan-Meier analysis yielded a 70% 5-year shunt-free survival rate. On multivariate analysis, no variables could predict early or late ETV failure. Transient complications occurred in 6 patients (13%), but there were no ETV-related deaths or permanent morbidity. CONCLUSION: ETV is a safe and effective treatment for OHC, resulting in a high rate of long-term shunt independence with a low risk of complications. ETV should be considered the treatment of choice for patients with OHC and its development as a substitute to shunt placement should be encouraged in neurosurgically developing countries. Copyright 2009 S. Karger AG, Basel.
BACKGROUND: Endoscopic third ventriculostomy (ETV) has gained wide popularity as a first-line treatment for obstructive hydrocephalus (OHC). We have been performing ETV since 1998. We report our experience with this technique in the management of OHC. METHODS: Between 1998 and 2007, we performed 49 ETV procedures in 46 patients suffering from OHC. Medical records were retrospectively reviewed. Success was defined as shunt-free survival. RESULTS: There were 29 males and 17 females with a mean age of 23 years (6 months-65 years). Aqueductal stenosis and tectal tumor were the most common etiologies (63%). Seven patients (15.6%) had early ETV failure. Of 38 patients with initial success and available follow-up, shunt independence was achieved in 29 patients (76.3%) after a mean follow-up of 37 months. Kaplan-Meier analysis yielded a 70% 5-year shunt-free survival rate. On multivariate analysis, no variables could predict early or late ETV failure. Transient complications occurred in 6 patients (13%), but there were no ETV-related deaths or permanent morbidity. CONCLUSION: ETV is a safe and effective treatment for OHC, resulting in a high rate of long-term shunt independence with a low risk of complications. ETV should be considered the treatment of choice for patients with OHC and its development as a substitute to shunt placement should be encouraged in neurosurgically developing countries. Copyright 2009 S. Karger AG, Basel.
Authors: Sondre Tefre; Alexander Lilja-Cyron; Lisa Arvidsson; Jiri Bartek; Alba Corell; Axel Forsse; Andreas Nørgaard Glud; Sami Abu Hamdeh; Frederik Lundgaard Hansen; Antti Huotarinen; Conny Johansson; Olli-Pekka Kämäräinen; Tommi Korhonen; Anna Kotkansalo; Nadia Mauland Mansoor; Eduardo Erasmo Mendoza Mireles; Rares Miscov; Sune Munthe; Henrietta Nittby-Redebrandt; Nina Obad; Lars Kjelsberg Pedersen; Jussi Posti; Rahul Raj; Jarno Satopää; Nils Ståhl; Sami Tetri; Lovisa Tobieson; Marianne Juhler Journal: BMJ Open Date: 2022-01-31 Impact factor: 2.692