title: Endoscopic 3rd ventriculocisternostomy: procedural complications and long-term dysfunctions?
abstract: OBJECTIVE
  The endoscopic third ventriculostomy (ETV) has become the treatment of choice for managing non-communicating hydrocephalus. The aim of this study was to evaluate the efficacy and the morbi-mortality of this procedure and its long-term outcome.
  
  
  METHODS
  This retrospective study involved 82 consecutive patients treated for non-communicating hydrocephalus by ETV, in a single centre, between June 1999 and November 2008. The main criterion of efficacy was clinical improvement with shunt independence. The secondary criteria were the ventricular size (third and lateral ventricles) outcome and the procedural morbidity and mortality. In order to determine the predictive factors of dysfunction, a uni- and multivariate analysis was conducted.
  
  
  RESULTS
  Divided in two groups, the overall success rate was 65.4% in the paediatric group (n=26) and 83.9% in the adult group (n=56), after respectively a mean follow-up of 59.1±36.7 and 49.3±27.7 months. A procedural complication occurred in 5 patients (6.1%), with no procedure-related death. The predictive factors of ETV failure were an infectious aetiology and an age less than 16. Changes in ventricular size and success rate were independent.
  
  
  CONCLUSIONS
  ETV is an effective procedure at long-term for the management of non-communicating hydrocephalus with low morbidity. Therefore, it should be considered as first-line treatment. Cerebrospinal meningitis infection and young age both expose patients to possible dysfunction.
authors.affiliation: Department of neurosurgery, Rouen university hospital, Charles-Nicolle, 1, rue de Gérmont, 76031 Rouen cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Melot
authors.forename: S
authors.initials: S
authors.lastname: Curey-Lévêque
authors.forename: S
authors.initials: S
authors.lastname: Derrey
authors.forename: E
authors.initials: E
authors.lastname: Gérardin
authors.forename: A
authors.initials: A
authors.lastname: Borden
authors.forename: P
authors.initials: P
authors.lastname: Fréger
authors.forename: F
authors.initials: F
authors.lastname: Proust
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013995:Time; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000009:adverse effects / Q000379:methods; D055815:Young Adult
keywords: Complications; Endoscopic third ventriculocisternostomy; Hydrocéphalie non communicante; Long-term outcome; Non-communicating hydrocephalus; Suivi à long terme; Ventriculocisternostomie endoscopique du troisième ventricule