Endoscopic third ventriculostomy: the Lebanese experience.

Abstract:

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.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Rahme R,Rahme RJ,Hourani R,Moussa R,Nohra G,Okais N,Samaha E,Rizk T

doi

10.1159/000257525

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

361-7

issue

5

eissn

1016-2291

issn

1423-0305

pii

000257525

journal_volume

45

pub_type

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