Endoscopic third ventriculostomy in treatment of hydrocephalus

Paweł Sokal; Marcin Birski; Marcin Rusinek; Darek Paczkowski; Piotr Zieliński; Aleksandra Harat

doi:10.5114/wiitm.2011.30810

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abstract:

Original paper

Endoscopic third ventriculostomy in treatment of hydrocephalus

Paweł Sokal

,

Marcin Birski

,

Marcin Rusinek

,

Darek Paczkowski

,

Piotr Zieliński

,

Aleksandra Harat

Videosurgery Miniinv 2012; 7 (4): 280-285

DOI: https://doi.org/10.5114/wiitm.2011.30810

Online publish date: 2012/09/29

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Introduction: Endoscopic third ventriculostomy (ETV) is a minimally invasive method of treatment of obstructive hydrocephalus (HCP).

Aim: To investigate perioperative and intraoperative difficulties, failures and complications of ETV.

Material and methods: Seventy-three procedures of ETV were conducted in our department in the last 5 years on 69 patients with HCP of different etiology. In 4 patients we performed ETV twice. In 4 cases we used neuronavigation. In 6 cases ETV was performed in conjunction with endoscopic biopsy of the tumor. In 6 cases we had to repeat the procedure (4) or implant a ventriculo-peritoneal shunt (2) due to recurrence of symptoms.

Results: In our series we had 3 important complications: one thalamic injury and 2 intraventricular hemorrhages.

In 4 cases we observed postoperative hyperthermia with the presence of meningeal symptoms. Two cerebrospinal fluid (CSF) leaks were secured with additional stitches and 2 CSF infections were treated with antibiotics. In 1 patient epileptic seizers were observed. Three others complained of nausea and vomiting. The initial success rate of ETV is 70%.

Conclusions: Based on our material we conclude that ETV is a useful and helpful procedure in non-communicating HCP. It carries 4% perioperative risk of serious complications which can be reduced by proper selection of patients, detailed plan and skilful performance of surgery in experienced hands and meticulous postoperative care.

keywords:

Endoscopic third ventriculostomy in treatment of hydrocephalus

Paweł Sokal , Marcin Birski , Marcin Rusinek , Darek Paczkowski , Piotr Zieliński , Aleksandra Harat

ventriculostomy, endoscope, hydrocephalus

Paweł Sokal

,

Marcin Birski

,

Marcin Rusinek

,

Darek Paczkowski

,

Piotr Zieliński

,

Aleksandra Harat