Endoscopic Third Ventriculostomy (ETV) versus Ventriculoperitoneal Shunt (VPS) for pediatric hydrocephalus: a meta-analysis

Background:Using Endoscopic Third Ventriculostomy (ETV) or Ventriculoperitoneal Shunt (VPS) as standard technique of cerebrospinal fluid (CSF) diversion has been a debatable issue. To date, a meta-analysis on the best treatment for pediatric hydrocephalus is yet to be done. ETV has been reported to have successful outcomes in many studies. The objective of this meta-analysis is to know the effectiveness of ETV compared to VPS in pediatric hydrocephalus.Methods:This study used electronic articles published in PubMed, EBSCO, and Google Scholar from January 1990 until January 2017. Articles included were full-text observational study or randomized control trial in Bahasa or English. Surgical failure was compared for this meta-analysis. Statistical analysis was done by using Review Manager 5.Results:Five articles met our inclusion and exclusion criteria. The pooled risk ratio (ETV vs. VPS) of surgical failure was 0.95 [0.76, 1.19] for fixed effect model. This analysis had no or little heterogeneity (I2 = 18%; X2=0.25).Conclusion:In one year follow up, there is no superiority between both procedures in surgical failure. Limited studies have been conducted to compare the effectiveness of ETV compared with VPS for pediatric hydrocephalus management. Further studies comparing both treatments are required to know the best management for pediatric hydrocephalus.Keywords: ETV, VPS, pediatric hydrocephalus, meta-analysis