Complications of endoscopic third ventriculostomy.
OBJECTIVE
Although endoscopic third ventriculostomy (ETV) is considered as the first choice in the management of noncommunicating hydrocephalus, it is not without risk or complication.


METHODS
The patients who had undergone ETV only between 1998 and 2005 were retrospectively reviewed. There were 85 males and 70 females, and 173 ETVs were performed in 155 patients. The patients' age ranged from 2 months to 77 years. Complications were categorized as (1) intraoperative, (2) early postoperative (<1 month), and (3) late postoperative (>1 month). Follow-up of the patients ranged from 1 to 86 months.


RESULTS
Overall complication rate per patient was 15.4%, and complication per procedure was 18%. Complication rate significantly varied with the etiology of hydrocephalus (P = 0.013). The patients with Chiari type I malformation and tumor had no or very low complication rates. The complication risk was significantly higher in repeat endoscopic procedure (55.5%) than in the first procedure (10%; P = 0.0001).


CONCLUSIONS
ETV should be the first choice in the management of noncommunicating hydrocephalus. Training, experience, and meticulous technique will decrease the complication rate. Patients undergoing ETV should be followed in a similar manner to patients with cerebrospinal fluid shunts.
Erşahin
Yusuf
Y
Division of Pediatric Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey. yusuf.ersahin@ege.edu.tr
Arslan
Dilek
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D007839:Functional Laterality; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects*; D038361:Neuronavigation / Q000295:instrumentation; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013353:Subdural Effusion / Q000209:etiology; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000009:adverse effects* / Q000295:instrumentation