ENDOSCOPIC THIRD VENTRICULOSTOMY VS VENTRICULOPERITONEAL SHUNT IN OBSTRUCTIVE HYDROCEPHALUS IN TERMS OF POST-OPERATIVE COMPLICATIONS

MM SHAH; M KHAN; N AKHTAR; A TASSADAQ; Y SHAHZAD; I KHAN; Z MASOOD; Y ANWAR

doi:10.54112/bcsrj.v2024i1.1222

Authors

MM SHAH Department of Neurosurgery, Rawalpindi Teaching Hospital Rawalpindi, Pakistan
M KHAN Department of General Surgery, Rawalpindi Teaching Hospital Rawalpindi, Pakistan
N AKHTAR Department of Neurosurgery, Rawalpindi Teaching Hospital Rawalpindi, Pakistan
A TASSADAQ Department of Neurosurgery, Rawalpindi Teaching Hospital Rawalpindi, Pakistan
Y SHAHZAD Department of Neurosurgery, Rawal Institute of Health Sciences Islamabad, Pakistan
I KHAN Department Of Neurosurgery, Kulsum International Hospital Islamabad, Pakistan
Z MASOOD Department Of Neurosurgery, Kulsum International Hospital Islamabad, Pakistan
Y ANWAR Department of Neurosurgery, Rawalpindi Teaching Hospital Rawalpindi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1222

Keywords:

Ventriculoperitoneal Shunt, Endoscopic Third Ventriculostomy, Obstructive Hydrocephalus, Cerebrospinal Fluid.

Abstract

: Obstructive Hydrocephalus is a condition characterized by increased cerebrospinal fluid (CSF) volume within the brain's ventricular system, leading to clinical deterioration and disability. Without treatment, it can be fatal. Two primary treatment modalities are Ventriculoperitoneal Shunting (VPS) and Endoscopic Third Ventriculostomy (ETV), with ongoing debate over the superiority of one approach over the other. Objective: To compare the complications associated with Ventriculoperitoneal Shunting (VPS) and Endoscopic Third Ventriculostomy (ETV) in patients with obstructive hydrocephalus. Methods: A randomized controlled trial was conducted at a tertiary care hospital from April 15, 2024, to September 15, 2024. A total of 100 patients diagnosed with obstructive hydrocephalus were randomly allocated into two groups: 50 patients received VPS treatment, and 50 received ETV. Complications, including surgical site infection, seizures, hematoma, and CSF leakage, were recorded and analyzed. Results: Complications were observed in 36% (n=18) of patients in the VPS group compared to 16% (n=8) in the ETV group, with a statistically significant difference (p=0.023). Surgical site infections occurred in 8% (n=4) of VPS patients, while no infections were reported in the ETV group. Seizures were significantly more common in the VPS group, affecting 26% (n=13) compared to 8% (n=4) in the ETV group (p=0.017). Hematoma formation was observed in 4% (n=2) of VPS patients and 6% (n=3) of ETV patients. CSF leakage occurred in 4% (n=2) of VPS patients and 2% (n=1) of ETV patients. Conclusion: Endoscopic Third Ventriculostomy (ETV) demonstrated a significantly lower complication rate compared to Ventriculoperitoneal Shunting (VPS) in the management of obstructive hydrocephalus. These findings support ETV as a safer alternative with fewer associated complications.

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