Outcome Comparison of Endoscopic Third Ventriculostomy versus Ventriculoperitoneal Shunt in Obstructive Hydrocephalus

  • Ishfaque Ahmed Simair Department of Neurosurgery, AMC/PGMI, PINS, Lahore General Hospital, Lahore, Pakistan.
  • Hafiz Jawad Ali Department of Neurosurgery, Lahore General Hospital, Lahore, Pakistan.
  • Amjad Qureshi Department of Neurosurgery, Agha Khan University Hospital, Karachi, Pakistan.
  • Tarique Salah-ud-Din Department of Neurosurgery, AMC/PGMI, PINS, Lahore General Hospital, Lahore, Pakistan.
Keywords: Cerebrospinal Fluid, Endoscopic Third Ventriculostomy, Ventriculoperitoneal Shunt


Background and Objectives:  To assess the outcome of Endoscopic Third Ventriculostomy (ETV) versus Ventriculoperitoneal Shunt (VPS) in Obstructive Hydrocephalus in terms of infections, foreign bodies, cost-effectiveness, and length of hospital stay.

Materials and Methods:  It was a Randomized Controlled Trial study, in which 30 patients with Obstructive Hydrocephalus were divided into two groups one was treated with (ETV) and the other was treated with VP Shunt and the patients were followed up for 1 year.

Results:  Patients were divided into 2 groups, 15 were treated with ETV, and 15 were treated with VP Shunt. Length of stay for VP shunt was 7 ± 0.85 days and for ETV mean stay was 2.93 ± 1.1 days. The complication was observed in 4 (26.7%) treated with VP Shunt and in 3 (20%) patients with Endoscopic Third Ventriculostomy. In ETV, 3 (20%) patients had recurrence whereas in VP shunt in 1 (6.67%) had an infection and in 3 (20%) patients had recurrence (upper-end blockage) and the overall success rate was 76% in both the procedures and in VP Shunt 73.3% and ETV 80%. Overall there were no complications found in 23 (76.6%) patients, in 3 (10%) patient’s complications were found at 1st month, in 3 (10%) complications were observed at 3rd month, and in 1(3.3%) complication was recorded at 6th month.

Conclusion:  ETV was found better in terms of length of hospital stay, cost-effectiveness as well as minimal complication rate as compared to VP shunt.


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