Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children.
Summary of "Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children."
This study compares endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors.
Fifty-three pediatric patients with a midline posterior fossa tumor (32 medulloblastomas and 21 ependymomas) associated with marked hydrocephalus were studied. Patients were divided into two groups: group A (32 patients) operated by ETV with a mean follow-up of 27.4 months and group B (21 patients) operated by VPS with a mean follow-up of 25 months.
Both procedures proved to be effective clinically and radiologically. In group A, intraoperative bleeding occurred in two cases (6.2%) and cerebrospinal fluid leakage in one case (3.1%). In group B, shunt infection occurred in two cases (9.4%), one of these two cases died 4.5 months postoperatively from ventriculitis. Subdural collection occurred in two cases (9.4%), epidural hematoma in one case (4.7%), and upward brain herniation in one case (4.7%). Endoscopic third ventriculostomy proved to be superior due to shorter duration of surgery (15 min versus 35 min), lower incidence of morbidity (9.3% versus 38%), no mortality (0% versus 4.7%), and lower incidence of procedure failure (6.2% versus 38%).
The shorter duration of surgery, the lower incidence of morbidity, the absence of mortality, the lower incidence of procedure failure, and the significant advantage of not becoming shunt dependent make ETV be recommended as the first choice in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors.
Department of Neurosurgery, Faculty of Medicine, Cairo University, 81 Nasr Road, Nasr City, Cairo, Egypt, firstname.lastname@example.org.
This article was published in the following journal.
Name: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20737274
- DOI: http://dx.doi.org/10.1007/s00381-010-1263-2
After a time of domination of shunt placement, endoscopic third ventriculostomy (ETV) has been increasingly applied in treatment of obstructive hydrocephalus.
Since its advent, endoscopic third ventriculostomy (ETV) has been an effective alternative to shunt placement for the treatment of hydrocephalus. The aim of this study was to report the results of our...
Hydrocephalus is a disorder of abnormal accumulation of cerebrospinal fluid in the intracranial space, usually in the cerebral ventricles. The number of patients reaching reproductive age and intendin...
Object It is common practice to use a new contralateral bur hole for ventriculoperitoneal shunt (VPS) placement in subarachnoid hemorrhage (SAH) patients with an existing ventriculostomy. At Thomas Je...
Background. Arachnoid cysts account for 1% of intracranial mass lesions. Quadrigeminal cistern arachnoid cysts are even rarer lesions. We report 18 cases of quadrigeminal cistern arachnoid cysts treat...
The purpose of this study is to test and compare the efficacy of Endoscopic Third Ventriculostomy with shunting of Cerebrospinal fluid (CSF)for treatment for patients of Normal pressure Hy...
The objectives of this study are: - To describe the incidence of clinical features in adults with internal ventriculoperitoneal (VP) shunt infections, - To determine the...
In unselected cirrhotic patients with bleeding esophageal varices to compare the influence on mortality rate, duration of life, quality of life, and economic costs of treatment of: - E...
The Decompression Intervention of Variceal Rebleeding Trial (DIVERT) is a multi-center prospective randomized clinical trial comparing the radiologic procedure of transjugular intrahepatic...
Cancer of the gallbladder (CaGB) is one of the most common causes of malignant obstructive jaundice. Jaundice is the second most common presentation and occurs in 30-60% of patients with C...
Medical and Biotech [MESH] Definitions
Surgical creation of a communication between a cerebral ventricle and the peritoneum by means of a plastic tube to permit drainage of cerebrospinal fluid for relief of hydrocephalus. (From Dorland, 28th ed)
Surgical fistulization of the membranous labyrinth of the inner ear with mastoid, subarachnoid or cochlear shunt. This procedure is used in the treatment of MENIERE DISEASE.
Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.
Surgical venous shunt between the portal and systemic circulation to effect decompression of the portal circulation. It is performed primarily in the treatment of bleeding esophageal varices resulting from portal hypertension. Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, umbilicorenal, and umbilicocaval.
Surgical portasystemic shunt between the portal vein and inferior vena cava.