The Scanty Knowledge of Endoscopic Third Ventriculostomy in Infants

Rami Y. Alqroom, M. Al-Khawaldeh, Basel Makhamreh, F. Sha'ban, Feras Haddad, Hussam Abu-nowar, Basel Younes, N. Khasawneh, A. Shurbaji
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Abstract

Introduction: Hydrocephalus (HCP) remains one of the commonest pathologies treated in developing countries. Endoscopic third ventriculostomy (ETV) has become the alternative to shunt-divergen procedures in the treatment of many pathologies of the cerebral fluid in the brain. Age has been considered a limitation to perform the procedure, we started to perform ETV In younger patients earlier than many other units. Objectives: In this study, we demonstrate the overall efficacy of ETV in infants younger than 1-year of age and to subsequently report the outcome of this procedure. Methods: From 2000 till 2016 we have performed a total of 386 cases of ETV of all ages. 71-cases were infants (below 1-year of age). Our study was undertaken to evaluate these cases. Patients were divided into two subgroups according to the cause of hydrocephalus; obstructive HCP, communicating HCP. Results: Mean time for follow up was 52 months. Mean age at surgery was 137days (7- 351days). The population included 31-females and 40-males, while10 infants were premature. Success rates were; 91.6%, 63.6% correspond to each sub-group with an overall success rate of 73.24%. Conclusion: ETV in infants is feasible, technically more demanding. Success rate justifies the procedure to be performed in such age group of patients. ETV can be used, attentively, in cases of hydrocephalus associated with MMC, morbidity and mortality does not differ from the general population.
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婴儿第三脑室内窥镜造瘘术的知识不足
脑积水(HCP)仍然是发展中国家治疗的最常见的病理之一。内镜下第三脑室造口术(ETV)已成为分流手术的替代方案,用于治疗许多脑内脑液病变。年龄被认为是实施该手术的一个限制因素,我们开始在年轻患者中实施ETV,比许多其他单位都要早。目的:在这项研究中,我们证明了ETV在1岁以下婴儿中的总体疗效,并随后报告了该手术的结果。方法:自2000年至2016年,我们共对386例各年龄段的ETV进行了手术。1岁以下婴幼儿71例。我们的研究是为了评估这些病例。根据脑积水的病因将患者分为两个亚组;阻塞性HCP,通讯性HCP。结果:平均随访时间52个月。平均手术年龄为137天(7 ~ 351天)。研究对象中有31名女性和40名男性,10名婴儿是早产儿。成功率为;91.6%, 63.6%对应于每个子组,总体成功率为73.24%。结论:婴幼儿ETV是可行的,但技术要求较高。成功率证明了在这一年龄组的患者中进行手术的合理性。ETV可用于与MMC相关的脑积水病例,其发病率和死亡率与一般人群没有差异。
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