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Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis

Received: 29 March 2024     Accepted: 13 April 2024     Published: 28 April 2024
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Abstract

Introduction: Hydrocephalus, characterized by abnormal cerebrospinal fluid (CSF) accumulation, presents significant challenges requiring timely intervention to prevent neurological complications. Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) are primary surgical options, yet their relative efficacy and safety remain debated. This meta-analysis aims to compare ETV and VPS for hydrocephalus treatment, providing evidence-based insights to guide clinical decision-making. Objectives: To compare the efficacy of ETV and VPS in achieving symptom relief and radiological resolution of hydrocephalus. To evaluate the safety profiles of ETV and VPS by assessing perioperative and postoperative complication rates. To examine long-term outcomes following ETV or VPS placement. To conduct subgroup analyses based on patient characteristics influencing treatment effectiveness and safety. Methods: A comprehensive literature search was conducted in PubMed and Scopus databases to identify relevant studies comparing ETV and VPS for hydrocephalus treatment. Inclusion criteria encompassed comparative studies reporting efficacy and safety outcomes in pediatric and adult populations. Data extraction and quality assessment were performed using standardized protocols. Meta-analysis was conducted using appropriate statistical methods, with sensitivity and subgroup analyses conducted to assess robustness and variability. Results: Symptom improvement was comparable between ETV and VPS, with lower major complications associated with ETV. Mortality and postoperative complications favored ETV, although VPS exhibited lower CSF leakage risk. Overall success rates were similar, but ETV demonstrated superior safety profiles. Subgroup analyses revealed variations based on patient characteristics. Conclusion: ETV and VPS are effective in achieving symptomatic relief and radiological resolution of hydrocephalus, with ETV demonstrating superior safety profiles. Shared decision-making considering patient factors is crucial in selecting the most appropriate treatment approach. Further research is warranted to refine treatment algorithms and optimize outcomes for hydrocephalus patients.

Published in Clinical Neurology and Neuroscience (Volume 8, Issue 2)
DOI 10.11648/j.cnn.20240802.11
Page(s) 19-25
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Hydrocephalus, Endoscopic Third Ventriculostomy, Ventriculoperitoneal Shunting, Meta-Analysis, Efficacy, Safety, Complication, Outcome

References
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[2] Drake, J. M., Kestle, J. R., Milner, R., Cinalli, G., Boop, F., Piatt, J., & Haines, S. (1998). Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery, 43(2), 294–303.
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[11] Kong W, Yin C, Lv Y, Zhao W, Tang G, Wang Y. Endoscopic Third Ventriculostomy vs. Ventriculoperitoneal Shunt for Obstructive Hydrocephalus: A Meta-Analysis of Randomized Controlled Trials. Turk Neurosurg. 2023; 33(6): 960-966.
[12] Lu L, Chen H, Weng S, Xu Y. Endoscopic Third Ventriculostomy versus Ventriculoperitoneal Shunt in Patients with Obstructive Hydrocephalus: Meta-Analysis of Randomized Controlled Trials. World Neurosurg. 2019 Sep; 129: 334-340.
[13] Lin, F., Zhang, X., Rao, Y., Zheng, S., Liang, B., & Qin, M. (2023). Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in pediatric patients with post-infective hydrocephalus: A meta-analysis of randomized controlled trials. Neurology Asia, 28(2), 297–306.
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Cite This Article
  • APA Style

    Akbar, H., Yasir, M. U., Masood, D., Gardezi, F., Khalid, H., et al. (2024). Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis. Clinical Neurology and Neuroscience, 8(2), 19-25. https://doi.org/10.11648/j.cnn.20240802.11

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    ACS Style

    Akbar, H.; Yasir, M. U.; Masood, D.; Gardezi, F.; Khalid, H., et al. Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis. Clin. Neurol. Neurosci. 2024, 8(2), 19-25. doi: 10.11648/j.cnn.20240802.11

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    AMA Style

    Akbar H, Yasir MU, Masood D, Gardezi F, Khalid H, et al. Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis. Clin Neurol Neurosci. 2024;8(2):19-25. doi: 10.11648/j.cnn.20240802.11

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  • @article{10.11648/j.cnn.20240802.11,
      author = {Hamaida Akbar and Muhammad Umer Yasir and Daniyal Masood and Farrah Gardezi and Hareem Khalid and Muddsar Hameed and Muhammad Ali Hassan},
      title = {Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis
    },
      journal = {Clinical Neurology and Neuroscience},
      volume = {8},
      number = {2},
      pages = {19-25},
      doi = {10.11648/j.cnn.20240802.11},
      url = {https://doi.org/10.11648/j.cnn.20240802.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20240802.11},
      abstract = {Introduction: Hydrocephalus, characterized by abnormal cerebrospinal fluid (CSF) accumulation, presents significant challenges requiring timely intervention to prevent neurological complications. Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) are primary surgical options, yet their relative efficacy and safety remain debated. This meta-analysis aims to compare ETV and VPS for hydrocephalus treatment, providing evidence-based insights to guide clinical decision-making. Objectives: To compare the efficacy of ETV and VPS in achieving symptom relief and radiological resolution of hydrocephalus. To evaluate the safety profiles of ETV and VPS by assessing perioperative and postoperative complication rates. To examine long-term outcomes following ETV or VPS placement. To conduct subgroup analyses based on patient characteristics influencing treatment effectiveness and safety. Methods: A comprehensive literature search was conducted in PubMed and Scopus databases to identify relevant studies comparing ETV and VPS for hydrocephalus treatment. Inclusion criteria encompassed comparative studies reporting efficacy and safety outcomes in pediatric and adult populations. Data extraction and quality assessment were performed using standardized protocols. Meta-analysis was conducted using appropriate statistical methods, with sensitivity and subgroup analyses conducted to assess robustness and variability. Results: Symptom improvement was comparable between ETV and VPS, with lower major complications associated with ETV. Mortality and postoperative complications favored ETV, although VPS exhibited lower CSF leakage risk. Overall success rates were similar, but ETV demonstrated superior safety profiles. Subgroup analyses revealed variations based on patient characteristics. Conclusion: ETV and VPS are effective in achieving symptomatic relief and radiological resolution of hydrocephalus, with ETV demonstrating superior safety profiles. Shared decision-making considering patient factors is crucial in selecting the most appropriate treatment approach. Further research is warranted to refine treatment algorithms and optimize outcomes for hydrocephalus patients.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis
    
    AU  - Hamaida Akbar
    AU  - Muhammad Umer Yasir
    AU  - Daniyal Masood
    AU  - Farrah Gardezi
    AU  - Hareem Khalid
    AU  - Muddsar Hameed
    AU  - Muhammad Ali Hassan
    Y1  - 2024/04/28
    PY  - 2024
    N1  - https://doi.org/10.11648/j.cnn.20240802.11
    DO  - 10.11648/j.cnn.20240802.11
    T2  - Clinical Neurology and Neuroscience
    JF  - Clinical Neurology and Neuroscience
    JO  - Clinical Neurology and Neuroscience
    SP  - 19
    EP  - 25
    PB  - Science Publishing Group
    SN  - 2578-8930
    UR  - https://doi.org/10.11648/j.cnn.20240802.11
    AB  - Introduction: Hydrocephalus, characterized by abnormal cerebrospinal fluid (CSF) accumulation, presents significant challenges requiring timely intervention to prevent neurological complications. Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) are primary surgical options, yet their relative efficacy and safety remain debated. This meta-analysis aims to compare ETV and VPS for hydrocephalus treatment, providing evidence-based insights to guide clinical decision-making. Objectives: To compare the efficacy of ETV and VPS in achieving symptom relief and radiological resolution of hydrocephalus. To evaluate the safety profiles of ETV and VPS by assessing perioperative and postoperative complication rates. To examine long-term outcomes following ETV or VPS placement. To conduct subgroup analyses based on patient characteristics influencing treatment effectiveness and safety. Methods: A comprehensive literature search was conducted in PubMed and Scopus databases to identify relevant studies comparing ETV and VPS for hydrocephalus treatment. Inclusion criteria encompassed comparative studies reporting efficacy and safety outcomes in pediatric and adult populations. Data extraction and quality assessment were performed using standardized protocols. Meta-analysis was conducted using appropriate statistical methods, with sensitivity and subgroup analyses conducted to assess robustness and variability. Results: Symptom improvement was comparable between ETV and VPS, with lower major complications associated with ETV. Mortality and postoperative complications favored ETV, although VPS exhibited lower CSF leakage risk. Overall success rates were similar, but ETV demonstrated superior safety profiles. Subgroup analyses revealed variations based on patient characteristics. Conclusion: ETV and VPS are effective in achieving symptomatic relief and radiological resolution of hydrocephalus, with ETV demonstrating superior safety profiles. Shared decision-making considering patient factors is crucial in selecting the most appropriate treatment approach. Further research is warranted to refine treatment algorithms and optimize outcomes for hydrocephalus patients.
    
    VL  - 8
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    ER  - 

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