Patterns and Rates of Early Complications in Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus
DOI:
https://doi.org/10.36552/pjns.v28i4.1039Keywords:
Obstructive hydrocephalus, Endoscopic Third Ventriculostomy, ComplicationsAbstract
Objective: To evaluate the frequency and pattern of early complications of endoscopic third ventriculostomy in patients with obstructive hydrocephalus.
Materials and Methods: This descriptive case series was conducted at the Department of Neurosurgery, MTI/Lady Reading Hospital, Peshawar, involving patients diagnosed with obstructive hydrocephalus who underwent third endoscopic ventriculostomy under general anesthesia, followed by a seven-day monitoring period for complications such as wound infection, CSF leak, seizures, and meningitis.
Results: A total of 127 patients were enrolled. The patients' ages varied from 6 months to sixty years. The mean age of the patients was 36.41 ± 9.36 years. Male to female ratio was 2.4:1. Overall complications were observed in 20 patients (15.7%). The most common complication was a CSF leak observed in 07 patients (5.5%), followed by wound infection in 05 patients (3.9%), meningitis and seizures were reported in 4 patients (3.1%) each.
Conclusion: In terms of complications, endoscopic third ventriculostomy is a safe procedure with a lower complication rate. The CSF leak was the most common reported complication.
References
Chatterjee S, Harischandra L. Cerebrospinal fluid shunts–How they work: The basics. Neurology India. 2018;66(1):24-35. DOI: 10.4103/0028-3886.222820
Sgouros S, Kombogiorgas D. Cerebrospinal fluid shunts. In Cerebrospinal Fluid Disorders. 2016; 454-475. CRC Press.
Aihara Y, Kawamata T, Mitsuyama T, Hori T, Okada Y. Novel method for controlling cerebrospinal fluid flow and intracranial pressure by use of a tandem shunt valve system. Pediatric Neurosurgery. 2010;46(1):12-8. DOI: 10.1159/000314052
Bateman GA, Fiorentino M. Childhood hydrocephalus secondary to posterior fossa tumor is both an intra-and extraaxial process. Journal of Neurosurgery: Pediatrics. 2016;18(1):21-8.
DOI: 10.3171/2016.1.PEDS15676
El-Beltagy MA, Kamal HM, Taha H, Awad M, El-Khateeb N. Endoscopic third ventriculostomy before tumor surgery in children with posterior fossa tumors, CCHE experience. Child's Nervous System. 2010;26:1699-704. Doi: 10.1007/S00381-010-1180-4
Bognár L, Borgulya G, Benke P, Madarassy G. Analysis of CSF shunting procedure requirement in children with posterior fossa tumors. Child's nervous system. 2003;19:332-6.
DOI: 10.1007/S00381-003-0745-X
Demerdash A, Rocque BG, Johnston J, Rozzelle CJ, Yalcin B, Oskouian R, Delashaw J, Tubbs RS. Endoscopic third ventriculostomy: A historical review. British journal of neurosurgery. 2017;31(1):28-32.
DOI: 10.1080/02688697.2016.1245848
Bouras T, Sgouros S. Complications of endoscopic third ventriculostomy. World neurosurgery. 2013;79(2):S22-e9.
DOI: 10.1016/J.WNEU.2012.02.014
Yadav YR, Parihar VS, Ratre S, Kher Y. Avoiding complications in endoscopic third ventriculostomy. Journal of Neurological Surgery Part A: Central European Neurosurgery. 2015;76(06):483-94.
DOI: 10.1055/s-0035-1551828
Ullah Ma, Khan Fu, Usman M, Ishaq M, Khan Z. Frequency and Pattern of Early Complications after Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus. Pakistan Journal of Neurological Surgery. 2020;24(3):237-42.
DOI: 10.36552/PJNS.V24I3.466
Lin CT, Riva-Cambrin JK. Management of posterior fossa tumors and hydrocephalus in children: a review. Child's Nervous System. 2015:1781-9.
DOI: https://doi.org/10.1007/s00381-015-2781-8
F Foreman P, McClugage S, Naftel R, Griessenauer CJ, Ditty BJ, Agee BS, Riva-Cambrin J, Wellons J. Validation and modification of a predictive model of postresection hydrocephalus in pediatric patients with posterior fossa tumors. Journal of Neurosurgery: Pediatrics. 2013;12(3):220-6.
DOI: 10.3171/2013.5.PEDS1371
Frisoli F, Kakareka M, Cole KA, Waanders AJ, Storm PB, Lang SS. Endoscopic third ventriculostomy prior to resection of posterior fossa tumors in children. Child's Nervous System. 2019;35:789-94.
DOI: 10.1007/S00381-019-04125-Z
Fritsch MJ, Doerner L, Kienke S, Mehdorn HM. Hydrocephalus in children with posterior fossa tumors: role of endoscopic third ventriculostomy. Journal of Neurosurgery: Pediatrics. 2005;103(1):40-2. DOI: 10.3171/PED.2005.103.1.0040
Legaspi GD, Espiritu AI, Omar AT. Success and complication rates of endoscopic third ventriculostomy for tuberculous meningitis: a systematic review and meta-analysis. Neurosurgical Review. 2021;44(4):2201-9. DOI: 10.1007/s10143-020-01396-y
Ghani E, Zaidi GI, Nadeem M, Rehman L, Noman MA. Role of cerebrospinal fluid diversion in posterior fossa tumor surgery. Journal of the College of Physicians and Surgeons – Pakistan: JCPSP. 2003;13(6):333-6. DOI: 6.2003/JCPSP.333336
Lodha K, Jaiswal G, Gupta T, Parashar V, Singh Y. Endoscopic third ventriculostomy for hydrocephalus in infants: A single-center experience. Asian Journal of Neurosurgery. 2020;15(02):302-5.
DOI: 10.4103/AJNS.AJNS_17_20
Bouras T, Sgouros S. Complications of endoscopic
third ventriculostomy: a review. Journal of Neurosurgery: Pediatrics. 2011;7(6):643-9.
DOI: 10.3171/2011.4.PEDS10503
Verma R, Srivastava C, Ojha BK, Chandra A, Garg RK, Kohli M, Malhotra HS, Parihar A, Tripathi S. Complications encountered with ETV in infants with congenital hydrocephalus. Neurology India. 2021;69(Suppl 2):S520-5.
DOI: 10.4103/0028-3886.332252
Hilman S, Aristiady EB, Santiana L, Dewi DK, Nugraha HG. Third ventricular floor bowing indicates surgical success in patients undergoing endoscopic third ventriculostomy—systematic review and meta-analysis. World Neurosurgery. 2022;157: e88-93.
DOI: 10.1016/J.WNEU.2021.09.092
Hellwig D, Grotenhuis JA, Tirakotai W, Riegel T, Schulte DM, Bauer BL, Bertalanffy H. Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgical review. 2005;28:1-34. DOI: 10.1007/S10143-004-0365-2
Rubin RC, Hochwald GM. Reconstitution of cerebral cortical mantle following hydrocephalus. In Neurobiology of Cerebrospinal Fluid 2 1983(pp. 821-833). Boston, MA: Springer US.
DOI: 10.1007/978-1-4615-9269-3_52
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Amer Zaman, Ibrahim, Bilal Ahmad, Waseef Ullah, Waseef Ullah, Irshad KhanThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
