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CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(04): 1042-1047
DOI: 10.4103/ajns.AJNS_63_17
Original Article

Controlled trial to compare therapeutic efficacy of endoscopic third ventriculostomy plus choroid plexus cauterization with ventriculoperitoneal shunt in infants with obstructive hydrocephalus

Amir Navaei
Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Science, Tehran
,
Sara Hanaei
1   Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran
,
Zohreh Habibi
1   Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran
,
Morteza Jouibari
Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Science, Tehran
,
Vahid Heidari
1   Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran
,
Soheil Naderi
1   Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran
,
Farideh Nejat
1   Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran
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Context: Ventriculoperitoneal (VP) shunt and endoscopic third ventriculostomy (ETV) are the established surgical treatments for obstructive hydrocephalus (HCP). Powerful evidence regarding the best therapeutic approach for infants with obstructive HCP is lacked. Aims: Comparison of the therapeutic efficacy of VP shunt and ETV/choroid plexus cauterization (CPC) in infants with obstructive HCP. Settings and Design: This was a randomized, active control, unblind, single-center, clinical trial. Methods: Infants with obstructive HCP were randomly allocated to each intervention group (ETV/CPC or VP shunt). They were monitored for at least 6 months for any sign of raised intracranial pressure (rICP). The recurrence of rICP signs requiring surgical intervention was considered as intervention failure. Statistical Analysis: The association between intervention group and outcome was tested with Chi-square test, and P = 0.05 or less was considered statistically significant. Results: Of the total fifty patients entering the study, 49 were included in the final analysis, 27 of them were in VP shunt and 22 in ETV/CPC group. Seventeen patients (34%) were female and 33 (66%) were male with mean age of 3.74 ± 3.1 months (range = 10 days – 11 months). Thirty-nine (79.6%) were under 6 months of age and the remaining were 6 months or older. The overall success rate in 36-month follow-up was 88.5% and 68.2% for VP shunt and ETV/CPC, respectively, with the difference being not statistically significant. Conclusion: The current study determined no inferiority of ETV/CPC compared to VP shunt, and therefore, it may become an efficient treatment for obstructive HCP in infants.

Key-words:

Endoscopic third ventriculostomy - hydrocephalus - success - ventriculoperitoneal shunt


Publication History

Article published online:
14 September 2022

© 2018. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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