Long-Term Outcomes of Endoscopic Third Ventriculostomy in Adults



Waqar, Mueez, Ellenbogen, Jonathan R, Stovell, Matthew G, Al-Mahfoudh, Rafid, Mallucci, Conor ORCID: 0000-0002-5509-0547 and Jenkinson, Michael D ORCID: 0000-0003-4587-2139
(2016) Long-Term Outcomes of Endoscopic Third Ventriculostomy in Adults. WORLD NEUROSURGERY, 94. pp. 386-393.

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Abstract

<h4>Objective</h4>To describe long-term outcomes of endoscopic third ventriculostomy (ETV) in adults with hydrocephalus.<h4>Methods</h4>Single-institution retrospective review of adults treated with ETV between 1998 and 2006. Patient demographic, treatment, and follow-up data were collected. The patients were divided into 2 groups: primary ETV for patients with previously untreated or newly diagnosed hydrocephalus and secondary ETV for patients with a previous shunt presenting with shunt malfunction. ETV outcome was deemed successful if the patient remained shunt-free after ETV. Multivariate analysis was performed using Cox regression.<h4>Results</h4>The study population comprised 190 patients, with a median age of 43 years (range, 16-79 years). The median duration of follow-up was 112 months (range, 1-190 months). The primary ETV group contained 129 patients; the secondary ETV group, 61 patients. Operative complications occurred in 11 patients (6%). A successful outcome was obtained in 139 patients (73%). ETV failure occurred in 51 patients, with a median time to failure of 2 months (range, 0-124 months). Although the majority (86%) of ETV failures occurred within 2 years postoperatively, failure was noted in 3 cases between 5 and 10 years after intervention, including in 1 patient at a 124-month follow-up. In multivariate analysis, only previous shunt was found to influence outcomes (P = 0.021), with shorter ETV survival noted in patients with a previous shunt. Age, indication, and ETV success did not influence outcome.<h4>Conclusions</h4>ETV is a safe procedure with excellent rates of long-term efficacy; however, late failure can occur, and patients should be instructed to seek medical advice if symptoms recur. A previous shunt is associated with a higher ETV failure rate.

Item Type: Article
Uncontrolled Keywords: Endoscopic third ventriculostomy, Hydrocephalus, Long-term outcomes, Shunt
Depositing User: Symplectic Admin
Date Deposited: 01 Sep 2016 08:17
Last Modified: 19 Jan 2023 07:30
DOI: 10.1016/j.wneu.2016.07.028
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3003107