Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults.
BACKGROUND
The emphasis regarding intracranial neuroendoscopy has been traditionally advocated and focused on the role in pediatric patients, although a significant usage has developed in adult patients. In this study, we examine and contrast the role of predominantly intracranial neuroendoscopy in both a pediatric and adult population with a minimum postprocedure follow-up of 5 years.


METHODS
A retrospective review was conducted for patients in the two hospitals that manage neurosurgical care for Southern Alberta, Canada, undergoing neuroendoscopic surgery between 1994 and 2008. The pediatric group was defined as age ≤17 years and the adult group as age ≥18 years.


RESULTS
A total of 273 patients who underwent a total of 330 procedures with a mean postprocedure follow-up of 12.9 years were identified. There were 161 adult and 112 pediatric patients, and both groups underwent surgery by the same surgeons. The most common procedure was endoscopic third ventriculostomy, accounting for 55% of procedures. One postoperative death occurred in an adult patient. Endoscopic third ventriculostomy success 1-year postprocedure was 81%, with only three late-term failures. Postoperative infection was the most common serious complication (two pediatric/four adult patients). Adult and pediatric patients had similar major complication rates (4.2% vs 5.7%, p=0.547).


CONCLUSIONS
Neuroendoscopy overall had a similar role in both pediatric and adult neurosurgical populations, with the most commonly associated complication being infection. Neuroendoscopy is an important therapeutic modality in the management of appropriate adult patients.
Department of Neurosurgery,University of Calgary,Foothills Hospital,Calgary,Alberta,Canada.
Fady
F
Girgis
Department of Neurosurgery,University of Calgary,Foothills Hospital,Calgary,Alberta,Canada.
Roberto
R
Diaz
Department of Neurosurgery,University of Calgary,Foothills Hospital,Calgary,Alberta,Canada.
Walter
W
Hader
Department of Neurosurgery,University of Calgary,Foothills Hospital,Calgary,Alberta,Canada.
Mark
M
Hamilton
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000416:Alberta; D002170:Canada; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D020542:Third Ventricle / Q000601:surgery*; D014696:Ventriculostomy / Q000379:methods; D055815:Young Adult
adult; complications; neuroendoscopy; pediatric