Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: Success and failure.

Objective: To determine if endoscopic third ventriculostomy (ETV) is effective in the treatment of obstructive hydrocephalus. Study Design: Prospective study.  Setting: Department of Neurosurgery, Hayatabad Medical Complex, Peshawar. Period: February 2018 to March 2021. Material & Methods: Eighty Five patients underwent endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus all patients with obstructive hydrocephalus of any gender and age more than 6 months were included in the study.  Patients age less than 6 months, recurrent cases and those refuse to opt for ETV were excluded from our study. The information regarding patient demographic, etiology, complications of procedure were documented in proforma. Data was analyzed using SPSS version 20.0 and presented in form of tables. Results: In the current study out of 85 patients, 48(56.4%) were male and 37(43.5%) were females with male to female ratio=1.23. ETV had successful outcome in 66(77.6%) patients. The sign and symptoms of raised intracranial pressure resolved in all patients after ETV. Overall complication rate in our study was 22(25.8%). The commonest complication was inadequate ventriculostomy in 10(11.7%), per operative significant bleeding in 4(4.7%) of patient, seizure in 3(3.5%) of patients, CSF leak and intraventricular hemorrhage in 2(2.35%) respectively. Conclusion: ETV is minimally invasive, safe, effective mode of treatment for obstructive hydrocephalus. Success rate is higher in children below 5 years of age. The overall success rate varies from 70-80% in various studies.