Endoscopic third ventriculostomy in failed ventriculoperitoneal shunt in pediatric population

Ajay Choudhary; Shivender Sobti; Sourabh Zambre; Suryanarayanan Bhaskar

doi:10.4103/ajns.AJNS_117_20

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 937-940
DOI: 10.4103/ajns.AJNS_117_20

Original Article

Endoscopic third ventriculostomy in failed ventriculoperitoneal shunt in pediatric population

Authors

Ajay Choudhary

Department of Neurosurgery, ABVIMS and Dr. RML Hospital, New Delhi
Shivender Sobti

¹Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab
Sourabh Zambre

²Department of Neurosurgery, SGPGI, Lucknow, Uttar Pradesh
Suryanarayanan Bhaskar

³Department of Neurosurgery, AIIMS, Jodhpur, Rajasthan

Abstract

Introduction: Ventriculoperitoneal (VP) shunt malfunction is common in pediatric age group patients. There is a high complication rate and revision rate of VP shunt. Endoscopic third ventriculostomy (ETV) can alleviate these complications and can act as an effective alternative for the treatment of hydrocephalus in this age group of patients. Materials and Methods: The authors retrospectively reviewed the management and outcome of 36 failed VP shunts in pediatric patients for the treatment of hydrocephalus. The surgeries were performed between November 2010 and January 2016 in a tertiary care hospital. The minimal follow-up period was 3 months. We divided the patients into the following age groups: <1 year (eight infants), 1–10 years (18 children), and 10–18 years (10 children). The success of the procedure was determined by age, sex, type of hydrocephalus, and the number of shunt revisions and malfunction before ETV. Children with different age (P = 0.839) and sex group did not show any significant data (P = 0.798). Children with communicating hydrocephalus had a success rate of 52.9% (17 patients), and children with noncommunicating hydrocephalus had a success rate of 84.2% (19 patients). The success rate in children with only one shunt malfunction was 57.1% (21 patients), whereas in 15 children with two or more shunt malfunctions, the success rate of ETV was 86.7%. Conclusions: The authors conclude that ETV is an effective alternative for the treatment of hydrocephalus in children. Age does not present a contraindication for ETV in failed VP shunt.

Key-words:

Endoscopic third ventriculostomy - hydrocephalus - pediatric - ventriculoperitoneal shunt

Full Text

References

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