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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Long term follow-up of repeat endoscopic third ventriculostomy in obstructive hydrocephalus

Meeting Abstract

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  • Jana Rediker - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
  • Sonja Vulcu - Universitätsklinik für Neurochirurgie, Inselspital Bern , Bern, Switzerland
  • Leonie Eickele - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
  • Wolfgang Wagner - Klinik für Neurochirurgie, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
  • Joachim Oertel - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.04.03

doi: 10.3205/17dgnc022, urn:nbn:de:0183-17dgnc0227

Published: June 9, 2017

© 2017 Rediker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus provides excellent outcome. Nevertheless, repeat ETV in cases of ETV failure is under controversial discussion.

Methods: Between 1993 and 1999, 113 patients with obstructive hydrocephalus underwent a total of 126 ETVs at the Department of Neurosurgery, Mainz University Hospital. A very long term follow-up of up to 14 years could be achieved. All medical reports of patients who received ETV were reviewed and analyzed retrospectively with focus on ETV failure with following repeat ETV and its initial as well as very long term success.

Results: Of 31 patients with failure of initial ETV, 13 patients underwent repeat ETV: 3 patients during the first 3 months (early repeat ETV), the other 10 patients after 7 to 78 months (late repeat ETV, mean 33 months). All repeat ETVs were performed without complications. Follow-up evaluation after repeat ETV ranged from < 1 month up to 14 years (mean 7 years). Of the three early revisions, two ETV failed and one other patient died during follow up while only two of the late repeat ETV failed. Very long term success rate of late repeat ETV up to 14 years yielded 80%.

Conclusion: Repeat ETV in cases of late ETV failures represents an excellent treatment option for CSF circulation restoration up to 14 years of follow up. Repeat ETV in early ETV failure in contrast is disappointing; and factors of ETV failure should be analysed very carefully before a decision for repeat ETV is made.