Long-term reliability of endoscopic third ventriculostomy

Kadrian, David, van Gelder, James, Florida, Danielle Florida, Jones, Robert, Vonau, Marianne, Teo, Charles, Stening, Warwick and Kwok, Bernard (2008) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery, 62 Supp. 2: 614-621. doi:10.1227/01.neu.0000316265.59596.8c


Author Kadrian, David
van Gelder, James
Florida, Danielle Florida
Jones, Robert
Vonau, Marianne
Teo, Charles
Stening, Warwick
Kwok, Bernard
Title Long-term reliability of endoscopic third ventriculostomy
Journal name Neurosurgery   Check publisher's open access policy
ISSN 0148-396X
1524-4040
Publication date 2008-02-01
Year available 2008
Sub-type Article (original research)
DOI 10.1227/01.neu.0000316265.59596.8c
Open Access Status DOI
Volume 62
Issue Supp. 2
Start page 614
End page 621
Total pages 8
Place of publication Philadelphia, United States
Publisher Lippincott Williams and Wilkins
Language eng
Formatted abstract
Objective: To describe the short-term operative success and the long-term reliability of endoscopic third ventriculostomy (ETV) for treatment of hydrocephalus and to examine the influence of diagnosis, age, and previous shunt history on these outcomes.

Methods:  We retrospectively analyzed 203 consecutive patients from a single institution who had ETV as long as 22.6 years earlier. Patients with hydrocephalus from aqueduct stenosis, myelomeningocele, tumors, arachnoid cysts, previous infection, or hemorrhage were included.

Results: The overall probability of successfully performing an ETV was 89% (84-93%). There was support for an association between the surgical success and the individual operating surgeon (odds ratios for success, 0.44-1.47 relative to the mean of 1.0, P = 0.08). We observed infections in 4.9%, transient major complications in 7.2%, and major and permanent complications in 1.1% of 203 procedures. Age was strongly associated with long-term reliability. The longest observed reliability for the 13 patients 0 to 1 month old was 3.5 years. The statistical model predicted the following reliability at 1 year after insertion: at 0 to 1 month of age, 31% (14-53%); at 1 to 6 months of age, 50% (32-68%); at 6 to 24 months of age, 71% (55-85%); and more than 24 months of age, 84% (79-89%). There was no support for an association between reliability and the diagnostic group (n = 181, P = 0.168) or a previous shunt. Sixteen patients had ETV repeated, but only 9 were repeated after at least 6 months. Of these, 4 procedures failed within a few weeks, and 2 patients were available for long-term follow-up.

Conclusion: Age was the only factor statistically associated with the long-term reliability of ETV. Patients less than 6 months old had poor reliability.
Keyword Endoscopic
Hydrocephalus
Surgical procedure
Ventriculostomy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Reprint of: Kadrian, David, van Gelder, James, Florida, Danielle, Jones, Rober, Vonau, Marianne, Teo, Charles, Sterling, Warwick and Kwok, Bernard (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery, 56 6: 1271-1278.

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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