Endoscopic Third Ventriculostomy: The Lebanese Experience
2009; Karger Publishers; Volume: 45; Issue: 5 Linguagem: Inglês
10.1159/000257525
ISSN1423-0305
AutoresRalph Rahme, Rudy J. Rahme, Roula Hourani, Ronald Moussa, G. Nohra, Nabil Okais, Elie Samaha, Tony Rizk,
Tópico(s)Spinal Dysraphism and Malformations
Resumo<i>Background:</i> Endoscopic third ventriculostomy (ETV) has gained wide popularity as a first-line treatment for obstructive hydrocephalus (OHC). We have been performing ETV since 1998. We report our experience with this technique in the management of OHC. <i>Methods:</i> Between 1998 and 2007, we performed 49 ETV procedures in 46 patients suffering from OHC. Medical records were retrospectively reviewed. Success was defined as shunt-free survival. <i>Results:</i> There were 29 males and 17 females with a mean age of 23 years (6 months–65 years). Aqueductal stenosis and tectal tumor were the most common etiologies (63%). Seven patients (15.6%) had early ETV failure. Of 38 patients with initial success and available follow-up, shunt independence was achieved in 29 patients (76.3%) after a mean follow-up of 37 months. Kaplan-Meier analysis yielded a 70% 5-year shunt-free survival rate. On multivariate analysis, no variables could predict early or late ETV failure. Transient complications occurred in 6 patients (13%), but there were no ETV-related deaths or permanent morbidity. <i>Conclusion:</i> ETV is a safe and effective treatment for OHC, resulting in a high rate of long-term shunt independence with a low risk of complications. ETV should be considered the treatment of choice for patients with OHC and its development as a substitute to shunt placement should be encouraged in neurosurgically developing countries.
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