Comparison of Ventriculoperitoneal Shunt and Endoscopic Third Ventriculostomy In  the Management of Obstructive Hydrocephalus

Talha Makshoof Athar; Maqsood Akram; Zahid Hussain; Ahmed Hassaan Malik; Asif Rasheed; Muhammad Usman

doi:10.51253/pafmj.v76iSUPPL-5.13720

Authors

Talha Makshoof Athar Department of Neurosurgery, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Maqsood Akram Department of Neurosurgery, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Zahid Hussain Department of Neurosurgery, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Ahmed Hassaan Malik Department of Neurosurgery, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Asif Rasheed Department of Neurosurgery, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Muhammad Usman Department of Neurosurgery, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-5.13720

Keywords:

Hydrocephalus, Neurosurgery, Ventriculostomy

Abstract

Objective: To compare the clinical success rate of ventriculoperitoneal shunt (VP shunt) and endoscopic third ventriculostomy (ETV) in the treatment of obstructive hydrocephalus.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital (CMH) Rawalpindi, Pakistan, from Jul 2023 to Mar 2025.

Methodology: This study enrolled 100 patients presenting with radiologically confirmed obstructive (non-communicating) hydrocephalus, who were then divided into two groups of 50 patients each. Patients in Group-A (n=50) underwent VP shunting, while those in Group-B (n=50) were treated with ETV. All patients were followed till discharge and then weekly for first month and monthly for next five months. Clinical success rate was determined in terms of complications, re-operation and average hospital stay. Statistically significant association was determined by a p value <0.05.

Results: On follow up, neurological outcomes in terms of Glasgow Outcome Scale (GOS) scores were GOS 2 in 22 patients, GOS 3 in 30 patients, GOS 4 in 24 patients and GOS 5 in 24 patients. Clinical success rate was 94.00% in Group-A, while it was 96.00% in Group-B (p=0.646). Complication rate was 36.00% in Group-A as compared to 20% in Group-B (p=0.075). Re-operation rate was 48.00% in Group-A and 16.00% in Group-B (p=0.001), while average hospital stay duration was 8.10 ± 2.43 days in Group-A as compared to 5.42 ± 1.89 days in Group-B (p<0.001).

Conclusion: ETV provided better results as compared to VP shunt in management of obstructive hydrocephalus in our study in ..

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