Long-term outcomes of endoscopic third ventriculostomy for patients with obstructive hydrocephalus:report of 142 cases

GAN Wu; ZHOU Dong; ZHAN Sheng-quan; LIN Xiao-feng; GUO Wen-long

doi:10.13798/j.issn.1009-153X.2023.10.001

Abstract：Objective To investigate the long-term outcomes of endoscopic third ventriculostomy(ETV)in the treatment of patients with obstructive hydrocephalus.Methods The clinical data of 142 patients with obstructive hydrocephalus treated with EVT from January 2010 to August 2018 were retrospectively analyzed.Results All patients successfully completed the operation,the size of the stoma was 2～10 mm(average,5 mm).CT showed that the hydrocephalus was relieved in all patients after operation,and the symptoms were gradually improved in 119 patients(83.8%)and were not in 23 patients.Intracranial hemorrhage occurred in 26 patients(18.3%)who were recovered after conservative treatment.Intracranial infection occurred in 6 patients(4.2%)who were recovered after drug treatment.There was no obvious hemiplegia,disturbance of consciousness,diabetes insipidus,obvious memory impairment,basilar artery injury,oculomotor nerve injury.Ten patients were lost to follow-up,and the other 132 patients were followed up for 1～147 months(mean,89.7 months),of which 118 patients(89.4%)were followed up for more than 36 months.The first ETV failure occurred in 10 patients(7.6%),and the failure time ranged from 1 month to 37 months after operation.Of the failed 10 patients,8 patients underwent VPS after CT examination,1 patient underwent ETV again,and 1 patient died due to subdural hematoma after external ventricular drainage for acute hydrocephalus.Conclusions ETV is the first choice for the treatment of obstructive hydrocephalus,with high long-term effective rate and failure occurring more frequently within 3 years after surgery.Pay attention to follow-up,and ETV or VPS can be used to solve hydrocephalus again according to the condition.