Simultaneous endoscopic third ventriculostomy and ventriculoperitoneal shunt for infantile hydrocephalus.
OBJECTIVE
We analyzed a series of consecutive hydrocephalic infants treated with implantation of a ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) simultaneously.


METHODS
Between 1995 and 2006, we treated the 111 hydrocephalic infants. Among those patients, 31 infants underwent VPS and ETV simultaneously, and 45 patients underwent only VPS. The ETV plus VPS group had 17 males and 14 females with a mean age of 6.32 months. The VPS only group consisted of 25 males and 20 females with a mean age of 4.43 months. There was no difference in etiology of hydrocephalus or clinical characteristics between the two groups. We compared shunt effectiveness by calculating the pre- and postoperative ventricular index and shunt failure rates during the follow-up period between the two groups. The follow-up period ranged from 6 to 140 months (mean, 53.23 months) in the ETV plus VPS group and from 6 to 148 months (mean, 75.98 months) in the VPS only group. The success rate was 83.9% (26 of 31) in the ETV plus VPS group and 68.9% (31 of 45) in the VPS only group. There were three infections and two shunt obstructions in the ETV plus VPS group versus eight obstructions, five infections, and one overdrainage in the VPS group. The preoperative and postoperative ventricular ratio of both groups showed statistically significant change (P < 0.000).


CONCLUSIONS
This simultaneous procedure could be the first choice of action for the hydrocephalic patients less than 1 year old.
Shim
Kyu-Won
KW
Department of Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Kim
Dong-Seok
DS
Choi
Joong-Uhn
JU
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods*; D014696:Ventriculostomy / Q000379:methods*