Abstract
Aim: Endoscopic th rd Ventriculostomy (ETV) is a routine and safe procedure for treatment obstructive hydrocephalus. The aim of our study was to evaluate EVS success rate in treating obstructive hydrocephalus in paediatrc patients with forrner ventriculo-peritoneal (V- P) shunt irnplantation.
Material and methods: We performed ETV in 36 patients with former V-P drainage implantation between 2001 and October 2011, Pre-surgica| bran MR performed in all patients confirmed an obstruction in aqueduct or outflow parts of the fourth ventricle. During the surgery, the V-P shunt was clipped and ETV was performed. ln patients with favourable clinical condition and functional stoma on VIR, the V-P shunt was removed 3 months after the ETV.
In indicated patients, the Ommaya reservoir was inserded to enable emergency cerebrospinal fluid tapping. Results: Our group of 36 patients involved 11 patients with congenital aqueduct stenosis, 14 patients with posthemorrhagic hydrocephalus, 6 patients with post-infection hydrocephalus and 5 patients with Chiari rnalíorrnation - associated hydrocephalus.
Nine patients underwent unsuccessful ETV in infancy. Patients in whom V-P shunt could be removed three month after the ETV were evaluated as successful ; 26 patients (72%) in our qroup were successful.
There was one serious complication in the group - one patient died 2.5 years after the surgery due to delayed ETV failure. Conclusion: The ETV is a method of choice in obstructive hydrocephalus even in patients with former V-P shunt impantation.
MR is feasible in acute or scheduled V-P shunt surgical revision. Hydrocephalus may be solved endoscopically in patients with confirmed obstruction in the ventricular system.