Endoscopic Third Ventriculostomy in the Management of Pediatric Hydrocephalus

Abstract

ventriculostomy (ETV) in the management of pediatric hydrocephalus, comparing its efficacy and safety with ventriculoperitoneal shunting (VPS). The study also aims to identify the main prognostic factors associated with the success or failure of the procedure and discuss the impact of ETV on patients' quality of life, as well as highlight recent technological advances that may influence surgical outcomes. A comprehensive literature review was conducted using PubMed, LILACS, and Scopus databases, focusing on terms related to “Endoscopic Third Ventriculostomy,” “Hydrocephalus,” “Quality of Life,” and “Surgical Complications.” Ten relevant articles addressing the efficacy, safety, complications, and prognostic factors of ETV were selected. ETV proved to be an effective alternative to VPS, especially in patients with obstructive hydrocephalus. The procedure's success was higher in children over one year old and those with aqueductal stenosis. Factors such as age below one year, post-hemorrhagic hydrocephalus, and the presence of ventricular septations were associated with an increased risk of early failure. The main complications included recurrence of hydrocephalus, infection, and premature closure of the stoma. ETV is a safe and effective technique for managing pediatric hydrocephalus, particularly in children with obstructive hydrocephalus and over one year of age. Although its effectiveness is influenced by multiple prognostic factors, the procedure offers significant advantages over VPS in terms of quality of life and long-term complication reduction. Future studies, especially long-term ones, are essential to define more precise indication criteria and improve clinical outcomes.