title: Ventriculocisternostomy versus ventriculoperitoneal shunt in the treatment of hydrocephalus: a retrospective, long-term observational study.
abstract: OBJECTIVE
  The goal of this study was the retrospective analysis of long-term data on endoscopic ventriculocisternostomy versus ventriculoperitoneal shunt placement in the treatment of hydrocephalus.
  
  
  METHODS
  A total of 159 patients were included in the study. One hundred and twenty-three patients received a ventriculoperitoneal shunt, whereas 36 patients were treated with an endoscopic procedure. Only patients with a postoperative observation period of at least 3 years were included in the analyses of the long-term data. In addition to general patient and operation data, the number and frequency of perioperative complications (infections, dysfunctions) and the frequency and type of necessary revision operations were collected.
  
  
  RESULTS
  The average observation period was 69 months for both groups. The risk of operative revision was significantly elevated in the shunt group despite a comparable observation period. Whereas 86.11% of the endoscopy group did not require an operative revision, that only applied to 68.85% of the shunt group. The complication rate was 42.7% in the shunt group per procedure, which was clearly higher than in the endoscopy group at only 9.4%.
  
  
  CONCLUSIONS
  The risk of operative revision and/or complications is significantly lower in the endoscopic ventriculocisternostomy group compared to the ventriculoperitoneal shunt group. Given the appropriate indication, endoscopic ventriculocisternostomy is thus the treatment of choice.
authors.affiliation: Department of Neurosurgery, University of Lübeck, Lübeck, Germany. Electronic address: jan.gliemroth@uk-sh.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Gliemroth
authors.affiliation: Medical Clinic 3, HELIOS Clinic, Wuppertal, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Käsbeck
authors.affiliation: Department of Neurosurgery, Asklepios Clinic, Altona, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Kehler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D014696:Ventriculostomy / Q000009:adverse effects*; D055815:Young Adult
keywords: Communicating hydrocephalus; Comparative study; Non-communicating hydrocephalus; Ventriculocisternostomy; Ventriculoperitoneal shunt