Introduction: The objective of this study is to analyze whether endoscopic third ventriculostomy (ETV) has replaced ventriculoperitoneal (VP) shunt for treating obstructive hydrocephalus or not.
Methods: This observational study was conducted in Neurosurgery Department of Post Graduate Medical Institute, Lady Reading Hospital Peshawar from May 2010 to April 2012. Patients with obstructive hydrocephalus due to aqueductal stenosis, tectal and non-tectal tumor were included in the study, while patients with blocked shunt, congenital hydrocephalus and post-infectious were excluded. The choice of CSF diversion procedure, either ETV (Group A) or VP shunt (Group B) was randomly assigned. A minimum follow up of 6 months was done. Data was analyzed using SPSS software version 17.
Results: There were 155 patients, 72 males and 83 females in Group A, while total of 147 patients in Group B. Success rate in terms of clinical and/or radiological improvement was 71% and 67% in Group A and Group B respectively. Complications were seen in 18 patients including mortality in 3 patients in Group A, while in group B the complication rate was 15%.
Conclusions: ETV has replaced VP shunt; furthermore it is effective, safe, economical and successful procedure in patients with obstructive hydrocephalus as an initial line of management.
Patient Care: This research will improve patient care by avoiding unnecessary complications and lifelong dependency on ventriculoperitoneal shunt.
Learning Objectives: By the conclusion of this talk, participants should be able to learn the alternative treatment modality for obstructive hydrocephalus.