Long-Term Outcome of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

Gangemi, M; Mascari, Carmelo; Maiuri, Francesco; Godano, Umberto; Donati, P; Longatti, Pierluigi

doi:10.1055/s-2007-990305

Cited by 75 publications

(40 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In other cases, the hydrocephalus is an acquired condition that develops later in life due to a brain tumor or cyst, head injury, or an infection such as meningitis. In another study Gangemis et al 9 presented 140 patients with obstructive hydrocephalus and have reported that the common etiology of hydrocephalus was acquiductal stenosis in 95 cases and compression by tumour in 45 cases. In present study, the etiology of hydrocephalus is acquiductal stenosis in 31 cases and compression by tumour in 29 cases which is consistent with the previous study.…”

Section: Discussionmentioning

confidence: 99%

Demographic Characteristics and Etiology of Hydrocephalus Patients attended at Tertiary Care Hospital in Bangladesh

Rahman

Haque

Islam

et al. 2017

J. Natl Inst. Neurosci Bangladesh

View full text Add to dashboard Cite

Background: Hydrocephalous can occur at any age. Objectives: The purpose of the present study was to see the Demographic Characteristics and Etiology of Hydrocephalus Patients. Methodology: This cross sectional study was conducted in the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University, Dhaka from April 2009 to September 2010 for a period of one and half year. Patients presented with obstructive hydrocephalus at any age with both sexes were included as study population. Detailed socio-demographic history as well as the associated etiological factors was recorded in pre designed data collection sheet. Result: A total number of 60 obstructive hydrocephalous patients were recruited for this study after fulfilling the inclusion and exclusion criteria. The mean age with SD was 17.95±19.15. Acquedctal stenosis was the most common etiology of hydrocephalous which was 31(51.7%) cases followed by posterior fossa midline tumour, CPA tumour and pineal region tumour which were 14 (23.3%) cases, 9(15.0%) cases and 6(10.0%) cases respectively. Conclusion: Obstructive hydrocephalous is most commonly found in younger age group which is caused by acquedctal stenosis. [Journal of National Institute of Neurosciences Bangladesh, 2015;1(2): [47][48][49]

show abstract

Section: Discussionmentioning

confidence: 99%

Demographic Characteristics and Etiology of Hydrocephalus Patients attended at Tertiary Care Hospital in Bangladesh

Rahman

Haque

Islam

et al. 2017

J. Natl Inst. Neurosci Bangladesh

View full text Add to dashboard Cite

show abstract

“…It also offers the possibility of using ETV for treatment of associated hydrocephalus. 9,11 Ventricular tumors represent a heterogeneous group in terms of histology and therapy and often present with common clinical history and radiological aspects. These lesions can be benign or malignant and may simulate malformative or infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

“…9,11 Endoscopic navigation to detect the lesion in patients with small ventricles is also possible using frameless neuronavigation. 1,18,22 Because intra-and paraventricular tumors account for just 2% of all intracranial tumors, studies regarding the effectiveness and safety of endoscopic biopsy have been limited to just a few series of patients.…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience

Fiorindi

Benvenuti

et al. 2011

FOC

View full text Add to dashboard Cite

Object Although neuroendoscopic biopsy is routinely performed, the safety and validity of this procedure has been studied only in small numbers of patients in single-center reports. The Section of Neuroendoscopy of the Italian Neurosurgical Society invited some of its members to review their own experience, gathering a sufficient number of cases for a wide analysis. Methods Retrospective data were collected by 7 centers routinely performing neuroendoscopic biopsies over a period of 10 years. Sixty patients with newly diagnosed intraventricular and paraventricular tumors were included. No patient harboring a colloid cyst was included. Data regarding clinical presentation, neuroimaging findings, operative techniques, pathological diagnosis, postoperative complications, and subsequent therapy were analyzed. Results In all patients, a neuroendoscopic tumor biopsy was performed. In 38 patients (64%), obstructive hydrocephalus was present. In addition to the tumor biopsy, 32 patients (53%) underwent endoscopic third ventriculostomy (ETV), and 7 (12%) underwent septum pellucidotomy. Only 2 patients required a ventriculoperitoneal shunt shortly after the endoscopy procedure because ETV was not feasible. The major complication due to the endoscopy procedure was ventricular hemorrhage noted on the postoperative images in 8 cases (13%). Only 2 patients were symptomatic and required medical therapy. Infection occurred in only 1 case, and the other complications were all reversible. In no case did clinically significant sequelae affect the patient's outcome. Tumor types ranged across the spectrum and included glioma (low- and high-grade [27%]), pure germinoma (15%), pineal parenchymal tumor (12%), primary neuroectodermal tumor (4%), lymphoma (9%), metastasis (4%), craniopharyngioma (6%), and other tumor types (13%). In 10% of patients, the pathological findings were inconclusive. According to diagnosis, specific therapy was performed in 35% of patients: 17% underwent microsurgical removal, and 18% underwent chemotherapy or radiotherapy. Conclusions This is one of the largest series confirming the safety and validity of the neuroendoscopic biopsy procedure. Complications were relatively low (about 13%), and they were all reversible. Neuroendoscopic biopsy provided meaningful pathological data in 90% of patients, making subsequent tumor therapy feasible. Cerebrospinal fluid pathways can be restored by ETV or septum pellucidotomy (65%) to control intracranial hypertension. In light of the results obtained, a neuroendoscopic biopsy should be considered a possible alternative to the stereotactic biopsy in the diagnosis and treatment of ventricular or paraventricular tumors. Furthermore, it could be the only surgical procedure necessary for the treatment of selected tumors.

show abstract

“…3,6,17,35 The influence of age at the time of ETV on the long-term success should be mentioned. There are reports of low long-term success rates, e.g., 35% and 53%, in patient series comprised exclusively of children younger than 2 years.…”

Section: Fig 3 Influence Of Underlying Pathology On Long-term Etv Smentioning

confidence: 99%

Long-term results of endoscopic third ventriculostomy: an outcome analysis

Vulcu

Eickele

Cinalli

et al. 2015

JNS

View full text Add to dashboard Cite

T he technique of endoscopic third ventriculostomy (ETV) has been under close evaluation as a treatment option for obstructive hydrocephalus. Although early on the procedure was associated with a very high, unacceptable complication rate, 41 more recent publications have reported success rates of about 70% and low complication rates, including mortality, around 0.5%-1.0%. 9,13,20,31,35 Nowadays, ETV is accepted as the gold standard for treatment of obstructive hydrocephalus. In comparison with ventriculoperitoneal shunting, a significantly lower complication rate and reoperation rate in the long term is expected. 2,10,26 Nevertheless, topics such as the prediction of ETV success, 4,12,26,28,42 period of highest failure rate, 26 and late deterioration after ETV 7,29 are still topics of discussion. However, current data are scarce, and the long-term efficacy of ETV is often under debate, since most studies have reported a rather short follow-up period, e.g., 8 months 13 or a few years. 1,22,23,40 Very few studies exist with a significantly longer follow-up, e.g., 4 years. 35This study investigates very long term success rates, up to 16 years, and the incidence of failures in the early and long-term postoperative periods after ETV. Methods Study DesignThe long-term outcome of ETV was evaluated through a retrospective analysis of all patients who underwent an abbreviatioN ETV = endoscopic third ventriculostomy. SubMitteD February 22, 2014. accepteD November 25, 2014. iNcluDe wheN citiNg Published online July 31, 2015; DOI: 10.3171/2014.11.JNS14414. DiScloSure J. Oertel reports that he is a consultant for Karl Storz Co. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. 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. Longterm 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 s...

show abstract

Long-Term Outcome of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

Cited by 75 publications

References 22 publications

Demographic Characteristics and Etiology of Hydrocephalus Patients attended at Tertiary Care Hospital in Bangladesh

Demographic Characteristics and Etiology of Hydrocephalus Patients attended at Tertiary Care Hospital in Bangladesh

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience

Long-term results of endoscopic third ventriculostomy: an outcome analysis

Contact Info

Product

Resources

About