Outcomes of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of paediatric hydrocephalus: Systematic review and meta-analysis

Minta, Katarzyna Julia; Kannan, Siddarth; Kaliaperumal, Chandrasekaran

doi:10.1007/s00381-023-06225-3

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Although conflicting findings were noted regarding mortality, recent studies such as those by found no significant difference in mortality between ETV and VPS, consistent with some of the findings reported in the meta-analysis [15].…”

Section: Discussionsupporting

confidence: 82%

Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis

Akbar,

Yasir,

Masood

et al. 2024

CNN

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Introduction: Hydrocephalus, characterized by abnormal cerebrospinal fluid (CSF) accumulation, presents significant challenges requiring timely intervention to prevent neurological complications. Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) are primary surgical options, yet their relative efficacy and safety remain debated. This meta-analysis aims to compare ETV and VPS for hydrocephalus treatment, providing evidence-based insights to guide clinical decision-making. Objectives: To compare the efficacy of ETV and VPS in achieving symptom relief and radiological resolution of hydrocephalus. To evaluate the safety profiles of ETV and VPS by assessing perioperative and postoperative complication rates. To examine long-term outcomes following ETV or VPS placement. To conduct subgroup analyses based on patient characteristics influencing treatment effectiveness and safety. Methods: A comprehensive literature search was conducted in PubMed and Scopus databases to identify relevant studies comparing ETV and VPS for hydrocephalus treatment. Inclusion criteria encompassed comparative studies reporting efficacy and safety outcomes in pediatric and adult populations. Data extraction and quality assessment were performed using standardized protocols. Meta-analysis was conducted using appropriate statistical methods, with sensitivity and subgroup analyses conducted to assess robustness and variability. Results: Symptom improvement was comparable between ETV and VPS, with lower major complications associated with ETV. Mortality and postoperative complications favored ETV, although VPS exhibited lower CSF leakage risk. Overall success rates were similar, but ETV demonstrated superior safety profiles. Subgroup analyses revealed variations based on patient characteristics. Conclusion: ETV and VPS are effective in achieving symptomatic relief and radiological resolution of hydrocephalus, with ETV demonstrating superior safety profiles. Shared decision-making considering patient factors is crucial in selecting the most appropriate treatment approach. Further research is warranted to refine treatment algorithms and optimize outcomes for hydrocephalus patients.

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Section: Discussionsupporting

confidence: 82%

Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis

Akbar,

Yasir,

Masood

et al. 2024

CNN

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Isolated Fetal Ventriculomegaly: Diagnosis and Treatment in the Prenatal Period

Zamłyński,

Zhemela,

Olejek

2024

Children

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Fetal ventriculomegaly (VM) is a defect of the central nervous system, typically diagnosed during the second-trimester ultrasound in fetuses with an atrial diameter (AD) of >10 mm. Non-isolated ventriculomegaly (NIVM) is heterogeneous in nature, coexisting with additional intracranial and/or extracranial malformations and genetic syndromes, resulting in an unfavorable prognosis for the further development of the child. Both the pregnancy management and counseling are dependent on the findings of combined ultrasound/MRI, genetic testing, and gestational age at diagnosis. The purpose of this review is to propose a hypothesis that diagnostic advancements allow to define the process of identification of the isolated forms of VM (IVM). Based on the evidence presented in the literature, we consider whether prenatal decompression for severe isolated VM (ISVM) is supported by the experimental trials and whether it might be implemented in clinical practice. Also, we describe the evolution of the diagnostic methods and expert opinions about the previously used prenatal decompression techniques for ISVM. In conclusion, we introduce the idea that fetal surgery centers have either reached or nearly reached the necessary level of expertise to perform such procedures. Endoscopic cystoventriculostomy (ETV) appears to be the most promising, as it is associated with minimal perinatal complications and favorable neurological outcomes in the neonatal period. Randomized trials with long-term neurodevelopmental follow-up of children who underwent prenatal decompression due to ISVM are necessary.

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Congenital Obstructive Hydrocephalus With Status Post-endoscopic Third Ventriculostomy Bilateral Subdural Hygroma and Pneumocephalus: A Case Report

Desai,

Sharath

2024

Cureus

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Pediatric neurosurgery faces a major difficulty in the treatment of hydrocephalus, a condition marked by an abnormal build-up of cerebrospinal fluid (CSF) in the brain. Its prevalence varies between 0.5 and 0.8 per 1,000 live births worldwide, with different etiologies, including congenital abnormalities and acquired diseases. With benefits including a lower risk of infection and avoiding issues due to the shunt, endoscopic third ventriculostomy (ETV) has become a beneficial surgical technique in certain instances. Bypassing clogged ventricular channels, ETV creates a new channel for CSF drainage. Despite its effectiveness, a thorough examination of underlying disease and anatomical variables is necessary for positive outcomes in patient selection. To give patients, the best possible care, this article attempts to summarize the prevalence of hydrocephalus and the part that ETV plays in managing it. It also emphasizes the significance of customized surgical techniques. It is critical to comprehend the incidence of hydrocephalus and available treatment choices to enhance the infant's quality of life and long-term outcomes.

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Outcomes of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of paediatric hydrocephalus: Systematic review and meta-analysis

Cited by 3 publications

References 17 publications

Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis

Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis

Isolated Fetal Ventriculomegaly: Diagnosis and Treatment in the Prenatal Period

Congenital Obstructive Hydrocephalus With Status Post-endoscopic Third Ventriculostomy Bilateral Subdural Hygroma and Pneumocephalus: A Case Report

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