التفاصيل البيبلوغرافية
| العنوان: |
Long-Term Outcomes of Endoscopic Third Ventriculostomy in Adults. |
| المؤلفون: |
Waqar, Mueez1,2 mwaqar@doctors.org.uk, Ellenbogen, Jonathan R.2, Stovell, Matthew G.2, Al-Mahfoudh, Rafid2, Mallucci, Conor2,3, Jenkinson, Michael D.2,4 |
| المصدر: |
World Neurosurgery. Oct2016, Vol. 94, p386-393. 8p. |
| مصطلحات موضوعية: |
*ENDOSCOPIC surgery, *HYDROCEPHALUS, *SURGICAL complications, *MULTIVARIATE analysis, *REGRESSION analysis, *DIAGNOSIS |
| مستخلص: |
Objective To describe long-term outcomes of endoscopic third ventriculostomy (ETV) in adults with hydrocephalus. Methods Single-institution retrospective review of adults treated with ETV between 1998 and 2006. Patient demographic, treatment, and follow-up data were collected. The patients were divided into 2 groups: primary ETV for patients with previously untreated or newly diagnosed hydrocephalus and secondary ETV for patients with a previous shunt presenting with shunt malfunction. ETV outcome was deemed successful if the patient remained shunt-free after ETV. Multivariate analysis was performed using Cox regression. Results The study population comprised 190 patients, with a median age of 43 years (range, 16–79 years). The median duration of follow-up was 112 months (range, 1–190 months). The primary ETV group contained 129 patients; the secondary ETV group, 61 patients. Operative complications occurred in 11 patients (6%). A successful outcome was obtained in 139 patients (73%). ETV failure occurred in 51 patients, with a median time to failure of 2 months (range, 0–124 months). Although the majority (86%) of ETV failures occurred within 2 years postoperatively, failure was noted in 3 cases between 5 and 10 years after intervention, including in 1 patient at a 124-month follow-up. In multivariate analysis, only previous shunt was found to influence outcomes ( P = 0.021), with shorter ETV survival noted in patients with a previous shunt. Age, indication, and ETV success did not influence outcome. Conclusions ETV is a safe procedure with excellent rates of long-term efficacy; however, late failure can occur, and patients should be instructed to seek medical advice if symptoms recur. A previous shunt is associated with a higher ETV failure rate. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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