Endoscopic Septostomy for Treatment of Complex Hydrocephalus: A Single Center Retrospective Cohort

Abstract

Objective The objective was to present the initial experience with endoscopic septostomy in a Brazilian public hospital.

Methods A retrospective analysis was conducted on patients who underwent neuroendoscopic septostomy at the Department of Neurosurgery of Cristo Redentor Hospital in Porto Alegre from 2015 to 2021.

Results In the period analyzed, 14 patients underwent endoscopic septostomy. The mean age of the patients was 41.86 years; 11 were male and 3 were female. The etiologies of hydrocephalus included ventricular inflammatory conditions, neoplasms, neurocysticercosis, and intraventricular cysts. Following septostomy, 64% of the patients exhibited clinical and radiological improvement. Complications occurred in 29% of the cases, including intraventricular hemorrhage and thalamic contusion. Four deaths were observed, all related to clinical complications or progression of the underlying disease.

Conclusion Endoscopic septostomy is an effective and safe procedure for treating complex hydrocephalus of different etiologies. Surgical outcomes are related to the learning curve with neuroendoscopy, and the benefits for patients are evident, considering the possibility of safely and effectively performing simultaneous endoscopic procedures with septostomy.

Resumo

Objetivo O objetivo foi apresentar a experiência inicial com septostomia endoscópica em um hospital público brasileiro.

Métodos Uma análise retrospectiva foi conduzida em pacientes submetidos à septostomia neuroendoscópica no Departamento de Neurocirurgia do Hospital Cristo Redentor em Porto Alegre, de 2015 a 2021.

Resultados No período analisado, 14 pacientes foram submetidos à septostomia endoscópica. A média de idade dos pacientes foi de 41,86 anos; 11 eram do sexo masculino e 3 do sexo feminino. As etiologias da hidrocefalia incluíram condições inflamatórias ventriculares, neoplasias, neurocisticercose e cistos intraventriculares. Após a septostomia, 64% dos pacientes apresentaram melhora clínica e radiológica. Complicações ocorreram em 29% dos casos, incluindo hemorragia intraventricular e contusão talâmica. Quatro óbitos foram observados, todos relacionados a complicações clínicas ou à progressão da doença subjacente.

Conclusão A septostomia endoscópica é um procedimento eficaz e seguro para o tratamento da hidrocefalia complexa de diferentes etiologias. Os resultados cirúrgicos estão relacionados à curva de aprendizado com a neuroendoscopia, e os benefícios para os pacientes são evidentes, considerando a possibilidade de realizar procedimentos endoscópicos simultâneos com a septostomia de maneira segura e eficaz.

Keywords

neuroendoscopy - hydrocephalus - Foramen of Monro - septum pellucidum

Palavras-chave

neuroendoscopia - hidrocefalia - Forame de Monro - septo pelúcido

Publikationsverlauf

Eingereicht: 04. Juli 2024

Angenommen: 18. Oktober 2024

Artikel online veröffentlicht:
18. November 2024

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