Success criteria in pediatric neuroendoscopic procedures. Proposal for classification of results after 67 operations

Ros, Bienvenido; Romero, Lorena; Ibáñez, Guillermo; Iglesias, Sara; Ríus, Francisca; Pérez, Sandra; Arráez, Miguel Ángel Escribano

doi:10.1007/s00381-012-1689-9

Cited by 18 publications

(12 citation statements)

References 49 publications

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“…Recently, some authors have identified risk factors and developed different systems to predict ETV success in children, among which the ETV Success Score (ETVSS) stands out as a reliable method that has been validated by many centers worldwide [2,14,22,24,25]. …”

Section: Introductionmentioning

confidence: 99%

The Success of Endoscopic Third Ventriculostomy in Children: Analysis of Prognostic Factors

2012

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Objective: The treatment of hydrocephalus in children with endoscopic third ventriculostomy (ETV) has particular features and is associated with different success rates (SR). The aim of this study was to identify putative factors that could influence the outcome of ETV in children. Methods: Clinical data of 114 consecutive patients under 18 years of age who underwent 116 consecutive ETVs from January 2000 to January 2010 were reviewed. Data were analyzed with regards to clinical and radiological SR. The actual long-term SR was compared to that predicted by the ETV Success Score (ETVSS) model. Results: The study group included 49 males (43%) and 65 females (57%) with a mean age of 6.17 ± 1.02 years (ranging from 11 days to 18 years) at surgery. Concerning the etiology of hydrocephalus, tumors and aqueductal stenosis (AS) were the most frequently observed, with each occurring in 33 cases (29%), followed by malformations in 24 (21%), cystic lesions in 6 (5%) and other etiologies in 18 patients (16%). The overall SR at the first ETV attempt was 80% (91/114), compared to 74.8% (variance 14.35, 95% CI 69.37-78.22) predicted by the ETVSS. Regarding age, SR was 58% in patients under 6 months of age, 65% in children between 6 months and 1 year, and 86% in children older than 1 year. SR for AS and hydrocephalus associated with posterior fossa tumors were 88 and 90%, respectively. Unsatisfactory results were related to previous intraventricular hemorrhage and infection. The overall complication rate in this series was 13%. Conclusion: ETV is safe and effective in children. In this series, the age of the patient and etiology of hydrocephalus were related to SR. Also, the ETVSS was accurate to predict outcome. In a long-term follow-up, surgical experience was statistically significant in reducing complications.

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Section: Introductionmentioning

confidence: 99%

The Success of Endoscopic Third Ventriculostomy in Children: Analysis of Prognostic Factors

2012

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Section: Discussionmentioning

confidence: 99%

“…Various classification systems are emerging not only to help predict outcome after endoscopic procedures for hydrocephalus, but also to aid in the selection of appropriate patients to maximize positive outcomes. 25,[42][43][44][45] The most common indication for ETV is aqueductal stenosis, either from congenital narrowing of the aqueduct or obstructive tumors such as tectal gliomas 46 and obstructive cysts. 47,48 Other indications include the fenestration of loculated compartments, 49,50 ventriculoperitoneal shunt malfunction, 26,27 and preresectional ETV for posterior fossa tumors.…”

Section: Hydrocephalusmentioning

confidence: 99%

Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

Girgis

Diaz

Hader

et al. 2015

Can. J. Neurol. Sci.

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Background: The emphasis regarding intracranial neuroendoscopy has been traditionally advocated and focused on the role in pediatric patients, although a significant usage has developed in adult patients. In this study, we examine and contrast the role of predominantly intracranial neuroendoscopy in both a pediatric and adult population with a minimum postprocedure follow-up of 5 years. Methods: A retrospective review was conducted for patients in the two hospitals that manage neurosurgical care for Southern Alberta, Canada, undergoing neuroendoscopic surgery between 1994 and 2008. The pediatric group was defined as age ≤17 years and the adult group as age ≥18 years. Results: A total of 273 patients who underwent a total of 330 procedures with a mean postprocedure follow-up of 12.9 years were identified. There were 161 adult and 112 pediatric patients, and both groups underwent surgery by the same surgeons. The most common procedure was endoscopic third ventriculostomy, accounting for 55% of procedures. One postoperative death occurred in an adult patient. Endoscopic third ventriculostomy success 1-year postprocedure was 81%, with only three late-term failures. Postoperative infection was the most common serious complication (two pediatric/four adult patients). Adult and pediatric patients had similar major complication rates (4.2% vs 5.7%, p = 0.547). Conclusions: Neuroendoscopy overall had a similar role in both pediatric and adult neurosurgical populations, with the most commonly associated complication being infection. Neuroendoscopy is an important therapeutic modality in the management of appropriate adult patients.RÉSUMÉ: Comparaison des interventions neuroendoscopiques intracrâniennes chez les enfants et chez les adultes. Contexte: Traditionnellement, l'emphase a été mise sur la neuroendoscopie intracrânienne chez les enfants et sur son rôle dans cette population de patients. Cependant, de telles interventions sont de plus en plus pratiquées chez des adultes. Nous examinons le rôle de la neuroendoscopie tant chez les enfants que chez les adultes et nous comparons son rôle dans ces deux populations de patients. Méthode: Nous avons procédé à une revue rétrospective des dossiers de patients ayant subi une chirurgie par neuroendoscopie entre 1994 et 2008 dans deux hôpitaux qui offrent des soins neurochirurgicaux dans la partie sud de l'Alberta, au Canada. Les patients du groupe pédiatrique étaient âgés de 17 ans ou moins et ceux du groupe adulte de 18 ans ou plus. Le suivi le plus court après l'intervention était de 5 ans. Résultats: Nous avons identifié 273 patients, dont 161 adultes et 112 enfants, qui ont subi au total 330 interventions, et chez qui un suivi moyen de 12,9 ans était disponible. Les deux groupes de patients ont été opérés par les mêmes chirurgiens. L'intervention la plus fréquemment effectuée était la ventriculostomie au niveau du 3e ventricule, ce qui représentait 5% des interventions. Un patient adulte est décédé en période post-opératoire. La ventriculostomie du 3e ventricule p...

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“…In this group, the proposal for treatment was of closure of MM and VP shunt at the same surgical time. VP shunt was chosen as the method of choice for treating hydrocephalus in these children after considering the benefits and drawbacks of endoscopic third ventriculostomy (ETV) in neonates with MM 12,17,21 .…”

Section: Methodsmentioning

confidence: 99%

Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele

Melo¹,

Pacheco²,

Melo³

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM). This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP) shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC), evaluation of fontanels, and measurement of lateral ventricular atrium (LVA) width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group), bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM.

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Success criteria in pediatric neuroendoscopic procedures. Proposal for classification of results after 67 operations

Abstract: A common classification of degrees of success, such as that proposed here, would aid the development of comparative and cooperative studies.

Cited by 18 publications

References 49 publications

The Success of Endoscopic Third Ventriculostomy in Children: Analysis of Prognostic Factors

The Success of Endoscopic Third Ventriculostomy in Children: Analysis of Prognostic Factors

Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele

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