Sonja Vulcu1, Leonie Eickele1, Giuseppe Cinalli2, Wolfgang Wagner3, Joachim Oertel1. 1. Neurosurgical Department, Universitaet des Saarlandes, Homburg/Saar, Germany; 2. Santobono-Pausilipon, Children's Hospital, Naples, Italy; and. 3. Neurosurgical Department, Universitaetsmedizin Mainz, Germany.
Abstract
OBJECT: Endoscopic third ventriculostomy (ETV) is the procedure of choice in the treatment of obstructive hydrocephalus. The excellent clinical and radiological success rates are well known. Nevertheless, very few papers have addressed the very long term outcomes of the procedure in very large series. The authors present a large case series of 113 patients who underwent 126 ETVs, and they highlight the initial postoperative outcome after 3 months and long-term follow-up with an average of 7 years. METHODS: All patients who underwent ETV at the Department of Neurosurgery, Mainz University Hospital, between 1993 and 1999 were evaluated. Obstructive hydrocephalus was the causative pathology in all cases. RESULTS: The initial clinical success rate was 82% and decreased slightly to 78% during long-term follow-up. Long-term success was analyzed using Kaplan-Meier curves. Overall, ETV failed in 31 patients. These patients underwent a second ETV or shunt treatment. A positive impact on long-term success was seen for age older than 6 months, and for obstruction due to cysts or benign aqueductal stenosis. The complication rate was 9% with 5 intraoperative and 5 postoperative events. CONCLUSIONS: The high clinical success rate in short-term and long-term follow-up confirms ETV's status as the gold standard for the treatment of obstructive hydrocephalus, especially for distinct pathologies. The patient's age and underlying pathology may influence the outcome. These factors should be considered carefully preoperatively by the surgeon.
OBJECT: Endoscopic third ventriculostomy (ETV) is the procedure of choice in the treatment of obstructive hydrocephalus. The excellent clinical and radiological success rates are well known. Nevertheless, very few papers have addressed the very long term outcomes of the procedure in very large series. The authors present a large case series of 113 patients who underwent 126 ETVs, and they highlight the initial postoperative outcome after 3 months and long-term follow-up with an average of 7 years. METHODS: All patients who underwent ETV at the Department of Neurosurgery, Mainz University Hospital, between 1993 and 1999 were evaluated. Obstructive hydrocephalus was the causative pathology in all cases. RESULTS: The initial clinical success rate was 82% and decreased slightly to 78% during long-term follow-up. Long-term success was analyzed using Kaplan-Meier curves. Overall, ETV failed in 31 patients. These patients underwent a second ETV or shunt treatment. A positive impact on long-term success was seen for age older than 6 months, and for obstruction due to cysts or benign aqueductal stenosis. The complication rate was 9% with 5 intraoperative and 5 postoperative events. CONCLUSIONS: The high clinical success rate in short-term and long-term follow-up confirms ETV's status as the gold standard for the treatment of obstructive hydrocephalus, especially for distinct pathologies. The patient's age and underlying pathology may influence the outcome. These factors should be considered carefully preoperatively by the surgeon.
Entities:
Keywords:
ETV = endoscopic third ventriculostomy; brain; endoscopic third ventriculostomy; hydrocephalus; long-term results; neuroendoscopy
Authors: José Aloysio da Costa Val Filho; Sebastião Nataniel da Silva Gusmão; Leopoldo Mandic Ferreira Furtado; Guaracy de Macedo Machado Filho; Fernando Levi Alencar Maciel Journal: Neurosurg Rev Date: 2021-02-23 Impact factor: 3.042
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