Turkish Neurosurgery 2023 , Vol 33 , Num 6
Endoscopic Third Ventriculostomy vs. Ventriculoperitoneal Shunt for Obstructive Hydrocephalus: A Meta-Analysis of Randomized Controlled Trials
Wei KONG1,Changyou YIN1,Yue LV1,Wei ZHAO1,Guotai TANG1,Yanbin WANG1
1The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Department of Neurosurgery, Yantai, China DOI : 10.5137/1019-5149.JTN.40204-22.2 AIM: To conduct a meta-analysis for investigating the safety and efficacy of endoscopic third ventriculostomy (ETV) and extracranial shunting for patients with obstructive hydrocephalus.

MATERIAL and METHODS: Randomized controlled trials (RCTs) of ETV and ventriculoperitoneal shunting (VPS) for obstructive hydrocephalus were analyzed systematically by using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also perused. Postoperative infection, postoperative cerebrospinal fluid (CSF) leakage, mortality and surgical success were the main outcomes of the analysis.

RESULTS: Among 841 selected studies, 6 RCTs evaluated ETV and VPS. Compared to VPS, ETV had lower postoperative infection incidence (risk ratio [RR]: 0.19, 95% confidence interval [CI]: 0.08-0.43, p=0.0001), postoperative CSF leakage (RR: 5.10, 95% CI: 1.19-21.89, p=0.03) VPS. VPS had no mortality as compared to ETV (RR 0.64, 95% CI: 0.26-1.56, p=0.32).

CONCLUSION: While VPS had no mortality in comparison to ETV, the latter showed lower incidences of major complications, such as postoperative infection and CSF leakage, than those of the former for patients with obstructive hydrocephalus. Keywords : Ventriculoperitoneal shunt, Endoscopic third ventriculostomy, Obstructive Hydrocephalus, Meta-Analysis

Corresponding author : Yanbin WANG, jietong-5@163.com