COMPARISON OF NEUROENDOSCOPY (ENDOSCOPIC THIRD VENTRICULOSTOMY) AND CONVENTIONAL SHUNT PLACEMENT FOR HYDROCEPHALUS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Hydrocephalus is a widespread surgical issue among neurosurgery, which is morbid at all age groups. The most common treatment has always been a ventriculoperitoneal shunt (VPS) placement; this form of treatment is linked to high frequency of complications. Endoscopic Third Ventriculostomy (ETV) has also developed as an alternative to surgical intervention, especially in obstruction of hydrocephalus, and possible advantage of less dependency on shunts and decreased complications. Objective: To compare the outcomes and complications of Endoscopic Third Ventriculostomy and Ventriculoperitoneal Shunting in the patient with the hydrocephalus and determine the factors that are related to the patient and will influence the results. Methods: This was a randomized controlled trial in the Department of Neurosurgery of a tertiary care hospital. One hundred and sixty-six patients aged between 5 and 90 years that have known hydrocephalus were recruited and assigned to two groups; ETV (n=83) and VPS (n=83). The baseline demographic, clinical, and radiological data were taken. One-month follow-up of patients was done. The outcomes evaluated were the neurological status measured by using the Glasgow Coma Scale, findings of imaging, hospital stay, and postoperative complications. The analysis of data was done in SPSS 25 with p ≤ 0.05 as the statistically significant value. Results: ETV was linked to improved neurological outcome, reduced hospitalization period, and reduced infection and general complication rate than VPS. The only complications that were observed were peritoneal complications in the VPS group. The success of the surgical procedure in general was greater in the ETV group. Conclusion: ETV is a safer and effective substitute of VPS that has better short-term results and reduced complications when used on some patients with hydrocephalus.