Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in non-communicating hydrocephalus (NCH): comparison of outcome profiles in Nigerian children
- 54 Downloads
Endoscopic third ventriculostomy (ETV) and ventriculo-peritoneal shunt (VPS) although recognized surgical options for non-communicating hydrocephalus have debatable applications.
We analysed a prospective cohort of age-matched children with non-tumor, non-communicating hydrocephalus treated with the two surgical modalities using clinically measurable parameters.
A single institution analysis of age-matched patients with non-communicating hydrocephalus treated with VPS or ETV over a 3-year period. Occipitofrontal circumference (OFC), milestone, shunt independence as well as complication profiles of patients were recorded and analysed. Mean follow-up period was 1.27 ± 0.19 years 95%CI). Data analysis were performed using SPSS version 15, Chicago, IL. Statistical tests were set at 95% significance level.
Fifty-five patients were enrolled, 25 patients had ETV, while 30 had VPS. Mean age was 2.3 ± 0.7 years (95% CI) with a range of 3 months to 4.5 years. Aqueductal stenosis was the most common indication. OFC profile decline was significant among the VPS group when compared with ETV group at 3 months follow-up (χ2 = 7.59, df = 1, p < 0.05). There was no difference among the two treatment groups χ2 = 2.47, df = 1, p > 0.05) in milestone profile. Thirteen percent of VPS, compared to (4%) ETV patients, had sepsis (χ2 = 4.59, df = 1 p < 0.05). Ninety-two percent of ETV patients remained shunt free, while 80% of shunted patients achieved ETV independence. Two patients died among the VPS group compared to one patient in the ETV group.
VPS compared to ETV is associated with an earlier milestone and OFC response. ETV is associated with lower rates of sepsis and mortality.
KeywordsEndoscopic third ventriculostomy Ventriculoperitoneal shunt Non-communicating hydrocephalus Milestones Outcome
Compliance with ethical standards
Conflict of interest
There are no conflicts of interest. The authors have no personal, financial or institutional interest in the materials or devices described in this article.
The abstract of this article was in part presented during the Nigerian Surgical Research meeting in December 2014 and was published as part of the proceedings of the Conference in the Nigerian Journal of Surgery, Enugu abstracts . It was also presented as a digital poster (Absract number: 751) at the neurosurgery forum on 29 September 2015, during the 2015 CNS annual meeting in New Orleans Louisianna, USA.
- 12.Kulkarni AV, Drake JM, Kestle JR, Mallucci CL, Sgourous S, Constantini S, Canadian Pediatric Neurosurgery Study Group (2010) Endoscopic third ventriculostomy vs cerebrospinal fluid shunt in the treatment of hydrocephalus in children: a propensity score-adjusted analysis. Neurosurgery 67(3):588–593CrossRefPubMedGoogle Scholar
- 18.Sipek A, Gregor V, Horacek J (2007) Birth defects in the Czech Republic in the period 1961–2005. Ceska Gynecokol 72(3):185–191Google Scholar
- 19.Uche EO, Ozor II (2011) Brain endoscopy in a tertiary hospital in southeast Nigeria: initial results. OJM 23(1–4):44–48Google Scholar
- 21.Uche EO, Okorie E, Ajuzieogu O, Iloabachie I, Onyia EE, Uche NJ (2015) Endoscopic third ventriculostomy and ventriculoperitoneal shunt in non-communicating hydrocephalus: comparison of outcome profiles in children treated at a tertiary hospital in Nigeria. Niger J Surg (abstract) 21(2):159–163Google Scholar
- 26.Yadav YR, Jaiswal S, Adam N, Basoor A, Jain G (2006) Endoscopic third ventriculostomy in infants. Neurol India 57:161–163Google Scholar