Abstract
Introduction
Few series compare endoscopic third ventriculostomies (ETV) and ventriculoperitoneal shunts (VPS). To avoid the complications after a shunt insertion, there is an increased tendency to perform a third ventriculostomy. We reviewed all pediatric patients operated in the French-speaking part of Switzerland for a newly diagnosed obstructive hydrocephalus since 1992 and compared the outcome of patients who benefited from ETV to the outcome of patients who benefited from VPS. There were 24 ETV and 31 VPS.
Discussion
At 5 years of follow-up, the failure rate of ETV was 26%, as compared to 42% for the VPS group. This trend is also found in the pediatric series published since 1990 (27 peer-reviewed articles analyzed).
Conclusion
In accordance to this trend, although a statistical difference cannot be assessed, we believe that ETV should be the procedure of choice in pediatric obstructive hydrocephalus.
Similar content being viewed by others
References
Abtin K, Thompson BG, Walker ML (1998) Basilar artery perforation as a complication of endoscopic third ventriculostomy. Pediatr Neurosurg 28(1):35–41
Aryan HE, Meltzer HS, Park MS, Bennett RL, Jandial R, Levy ML (2005) Initial experience with antibiotic-impregnated silicone catheters for shunting of cerebrospinal fluid in children. Childs Nerv Syst 21(1):56–61
Baykan N, Isbir O, Gercek A, Dagcnar A, Ozek MM (2005) Ten years of experience with pediatric neuroendoscopic third ventriculostomy: features and perioperative complications of 210 cases. J Neurosurg Anesthesiol 17(1):33–37
Beems T, Grotenhuis JA (2002) Is the success rate of endoscopic third ventriculostomy age-dependent? An analysis of the results of endoscopic third ventriculostomy in young children. Childs Nerv Syst 18(11):605–608
Brockmeyer D, Abtin K, Carey L, Walker ML (1998) Endoscopic third ventriculostomy: an outcome analysis. Pediatr Neurosurg 28(5):236–240
Cinalli G, Sainte-Rose C, Chumas P, Zerah M, Brunelle F, Lot G et al (1999) Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg 90(3):448–454
Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C (1998) The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 43(6):1323–1327 (discussion 1327–1329)
Davis SE, Levy ML, McComb JG, Masri-Lavine L (1999) Does age or other factors influence the incidence of ventriculoperitoneal shunt infections? Pediatr Neurosurg 30(5):253–257
Enger PO, Svendsen F, Wester K (2003) CSF shunt infections in children: experiences from a population-based study. Acta Neurochir (Wien) 145(4):243–248 (discussion 248)
Etus V, Ceylan S (2005) Success of endoscopic third ventriculostomy in children less than 2 years of age. Neurosurg Rev 28(4):284–288
Fischbein NJ, Ciricillo SF, Barr RM, McDermott M, Edwards MS, Geary S et al (1998) Endoscopic third ventriculocisternostomy: MR assessment of patency with 2-D cine phase-contrast versus T2-weighted fast spin echo technique. Pediatr Neurosurg 28(2):70–78
Fritsch MJ, Kienke S, Ankermann T, Padoin M, Mehdorn HM (2005) Endoscopic third ventriculostomy in infants. J Neurosurg 103(1 Suppl):50–53
Fukuhara T, Vorster SJ, Luciano MG (2000) Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery 46(5):1100–1109 (discussion 1109–1111)
Garton HJ, Kestle JR, Cochrane DD, Steinbok P (2002) A cost-effectiveness analysis of endoscopic third ventriculostomy. Neurosurgery 51(1):69–77 (discussion 77–78)
Gorayeb RP, Cavalheiro S, Zymberg ST (2004) Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg 100(5 Suppl Pediatrics):427–429
Grant JA, McLone DG (1997) Third ventriculostomy: a review. Surg Neurol 47(3):210–212
Hader WJ, Drake J, Cochrane D, Sparrow O, Johnson ES, Kestle J (2002) Death after late failure of third ventriculostomy in children. Report of three cases. J Neurosurg 97(1):211–215
Hopf NJ, Grunert P, Fries G, Resch KD, Perneczky A (1999) Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurgery 44(4):795–804 (discussion 804–806)
Hoppe-Hirsch E, Laroussinie F, Brunet L, Sainte-Rose C, Renier D, Cinalli G et al (1998) Late outcome of the surgical treatment of hydrocephalus. Childs Nerv Syst 14(3):97–99
Javadpour M, Mallucci C, Brodbelt A, Golash A, May P (2001) The impact of endoscopic third ventriculostomy on the management of newly diagnosed hydrocephalus in infants. Pediatr Neurosurg 35(3):131–135
Jones RF, Stening WA, Brydon M (1990) Endoscopic third ventriculostomy. Neurosurgery 26(1):86–91 (discussion 91–92)
Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C et al (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery 56(6):1271–1278 (discussion 1278)
Kanev PM, Sheehan JM (2003) Reflections on shunt infection. Pediatr Neurosurg 39(6):285–290
Kestle J, Drake J, Milner R, Sainte-Rose C, Cinalli G, Boop F et al (2000) Long-term follow-up data from the shunt design trial. Pediatr Neurosurg 33(5):230–236
Kestle JR, Walker ML (2005) A multicenter prospective cohort study of the Strata valve for the management of hydrocephalus in pediatric patients. J Neurosurg 102(2 Suppl):141–145
Kim SK, Wang KC, Cho BK (2000) Surgical outcome of pediatric hydrocephalus treated by endoscopic III ventriculostomy: prognostic factors and interpretation of postoperative neuroimaging. Childs Nerv Syst 16(3):161–168 (discussion 169)
Koch D, Wagner W (2004) Endoscopic third ventriculostomy in infants of less than 1 year of age: which factors influence the outcome? Childs Nerv Syst 20(6):405–411
Mohanty A, Vasudev MK, Sampath S, Radhesh S, Sastry Kolluri VR (2002) Failed endoscopic third ventriculostomy in children: management options. Pediatr Neurosurg 37(6):304–309
Navarro R, Gil-Parra R, Reitman AJ, Olavarria G, Grant JA, Tomita T (2006) Endoscopic third ventriculostomy in children: early and late complications and their avoidance. Childs Nerv Syst 22(5):506–513
Piatt JH Jr, Carlson CV (1993) A search for determinants of cerebrospinal fluid shunt survival: retrospective analysis of a 14-year institutional experience. Pediatr Neurosurg 19(5):233–241 (discussion 242)
Ralph K, Moylan P, Canady A, Simmons S (2000) The effects of multiple shunt revisions on neuropsychological functioning and memory. Neurol Res 22(1):131–136
Ray P, Jallo GI, Kim RY, Kim BS, Wilson S, Kothbauer K et al (2005) Endoscopic third ventriculostomy for tumor-related hydrocephalus in a pediatric population. Neurosurg Focus 19(6):E8
Robinson S, Kaufman BA, Park TS (2002) Outcome analysis of initial neonatal shunts: does the valve make a difference? Pediatr Neurosurg 37(6):287–294
Schroeder HW, Niendorf WR, Gaab MR (2002) Complications of endoscopic third ventriculostomy. J Neurosurg 96(6):1032–1040
Singh D, Gupta V, Goyal A, Singh H, Sinha S, Singh AK et al (2003) Endoscopic third ventriculostomy in obstructed hydrocephalus. Neurol India 51(1):39–42
Smyth MD, Tubbs RS, Wellons JC III, Oakes WJ, Blount JP, Grabb PA (2003) Endoscopic third ventriculostomy for hydrocephalus secondary to central nervous system infection or intraventricular hemorrhage in children. Pediatr Neurosurg 39(5):258–263
Tamburrini G, Caldarelli M, Di Rocco C (2002) Diagnosis and management of shunt complications in the treatment of childhood hydrocephalus. Rev Neurosurg 1(3)
Topczewska-Lach E, Lenkiewicz T, Olanski W, Zaborska A (2005) Quality of life and psychomotor development after surgical treatment of hydrocephalus. Eur J Pediatr Surg 15(1):2–5
Tuli S, Alshail E, Drake J (1999) Third ventriculostomy versus cerebrospinal fluid shunt as a first procedure in pediatric hydrocephalus. Pediatr Neurosurg 30(1):11–15
Tuli S, Tuli J, Drake J, Spears J (2004) Predictors of death in pediatric patients requiring cerebrospinal fluid shunts. J Neurosurg 100(5 Suppl Pediatrics):442–446
Vinchon M, Fichten A, Delestret I, Dhellemmes P (2003) Shunt revision for asymptomatic failure: surgical and clinical results. Neurosurgery 52(2):347–353 (discussion 353–356)
Wagner W, Koch D (2005) Mechanisms of failure after endoscopic third ventriculostomy in young infants. J Neurosurg 103(1 Suppl):43–49
Warf BC (2005) Comparison of 1-year outcomes for the Chhabra and Codman–Hakim micro precision shunt systems in Uganda: a prospective study in 195 children. J Neurosurg 102(4 Suppl):358–362
Warf BC (2005) Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective study in 550 African children. J Neurosurg 103(6 Suppl):475–481
Wellons JC III, Tubbs RS, Banks JT, Grabb B, Blount JP, Oakes WJ et al (2002) Long-term control of hydrocephalus via endoscopic third ventriculostomy in children with tectal plate gliomas. Neurosurgery 51(1):63–67 (discussion 67–68)
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
de Ribaupierre, S., Rilliet, B., Vernet, O. et al. Third ventriculostomy vs ventriculoperitoneal shunt in pediatric obstructive hydrocephalus: results from a Swiss series and literature review. Childs Nerv Syst 23, 527–533 (2007). https://doi.org/10.1007/s00381-006-0283-4
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-006-0283-4