Endoscopic third ventriculostomy versus ventriculoperitoneal shunt insertion for the management of pediatric hydrocephalus in African centers – A systematic review and meta-analysis

Author:

Jesuyajolu Damilola Alexander1,Zubair Abdulahi1,Nicholas Armstrong Kpachi2,Moti Terngu1,Osarobomwen Osamagie Ehi1,Anyahaebizi Israel1,Okeke Charles1,Davis Samuel Olawale1

Affiliation:

1. Department of Neurosurgery, Surgery Interest Group of Africa, Abijo, Lagos, Nigeria.

2. Department of Research, Surgery Interest Group of Africa, Abijo, Lagos, Nigeria.

Abstract

Background: Ventriculoperitoneal shunt (VPS) insertion and endoscopic third ventriculostomy (ETV) are common surgical procedures used to treat pediatric hydrocephalus. There have been numerous studies comparing ETV and VPS, but none from an African perspective. In this study, we sought to compare outcomes from African neurosurgical centers and review the associated complications. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in conducting this study. PubMed, Google Scholar, and African Journal Online were searched. Data on treatment successes and failures for ETV and VPS were pooled together and analyzed with a binary meta-analysis. A clinically successful outcome was defined as no significant event or complication occurring after surgery and during follow-up (e.g., infection, failure, CSF leak, malfunction, and mortality). Seven studies fully satisfied the eligibility criteria and were used in this review. Results: There was no statistically significant difference between the outcomes of ETV and VPS (OR- 0.27; 95% CI −0.39–0.94, P = 0.42). After reviewing the rates of complications of ETV and VPS from the identified studies, four were recurrent. The infection rates of ETV versus VPS were 0.02% versus 0.1%. The mortality rates were 0.01% versus 0.05%. The reoperation rates were 0.05% versus 0.3%, while the rates of ETV failure and shunt malfunction were 0.2% versus 0.2%. Conclusion: This study concludes that there is no significant difference between the outcomes of ETV and VPS insertion.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

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