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ORIGINAL ARTICLE
Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 1001-1004

Early surgical outcome of endoscopic third ventriculostomy in the management of obstructive hydrocephalus: A randomized control trial


1 Department of Neurotrauma Surgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
2 Department of Orthopedics, Gofargaon Upazila Health Complex, Mymensingh, Bangladesh
3 Department of Neurosurgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh
4 Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
5 Department of Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
6 Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh

Correspondence Address:
Mohammad Mahfuzur Rahman
Department of Neurotrauma Surgery, National Institute of Neurosciences and Hospital, Dhaka
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_376_16

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Background: Management of obstructive hydrocephalus is an important issue for the reduction of mortality and morbidity. Objectives: The aim of the present study was to assess the early surgical outcome of endoscopic third ventriculostomy (ETV) in the management of obstructive hydrocephalus. Methodology: This randomized controlled trial was conducted at the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from April 2009 to September 2010 for 1½ years. All patients presenting with obstructive hydrocephalus with the obstruction at or distal to the third ventricle and age 6 months and above were included in the study population. All the patients were divided into two groups named as Group A (experimental group) who were treated with ETV and Group B (control group) who were treated with ventriculoperitoneal shunt (VPS). The early surgical outcome was defined as outcomes within 1 month following surgical interventions. Pre- and post-operative outcomes of this study were measured. Results: A total number of sixty patients were recruited from which thirty patients were in Group A and the rest thirty patients were in Group B. The mean postoperative head circumference was 43.4 ± 7.1 cm and 47.8 ± 5.6 cm in VPS and ETV surgery, respectively (P ≤ 0.01). Postoperative vomiting was improved 24 (92.3%) in Group A and 23 (88.5%) in Group B (P < 0.05). Postoperative infection occurred in 1 (3.3%) case in Group A and 8 (26.7%) cases in Group B (P < 0.05). The success of the operation in Group A and Group B included 25 (83.3%) cases and 12 (40%) cases, respectively (P < 0.05). Conclusion: Early surgical outcome following ETV is better than VPS surgery in patients with obstructive hydrocephalus.


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