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


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


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.
Department of Neurosurgery, Military Clinical Hospital, Bydgoszcz, Poland.
Paweł
P
Sokal
Marcin
M
Birski
Marcin
M
Rusinek
Darek
D
Paczkowski
Piotr
P
Zieliński
Aleksandra
A
Harat
endoscope; hydrocephalus; ventriculostomy