Pediatric neuroendoscopy in Chile. Analysis of the first 100 cases

Abstract

The personal series of the first 100 cases of neuroendoscopy performed at the Pediatric Neurosurgery Service of the Institute of Neurosurgery Alfonso Asenjo in Santiago-Chile is presented. The patients were the first to undergo endoscopic operations for different types of hydrocephalus and their ages ranged from newborn up to 15 years. Their clinical records, surgical protocols, radiologic results, videos and follow-up are reviewed. A mortality of 2% and a morbidity of 7% were found in this group, hemorrhage, ventriculitis and CSF leakage being the main problems. Success was achieved in more than 75% of cases in the whole series. If we only consider the group of III ventriculostomies performed in noncommunicating hydrocephalus, our success rate rises to 90%. Follow-up ranges from 30 months in the first case to 2 months in the last case considered. All patients were operated on by the author using a rigid Gaab scope with 5.8 mm OD coupled to a Codman light source and a microcamera. Surgical technique was always the same using a right precoronal burr hole. Prophylaxis with vancomycin was indicated in all cases. General, partial and specific results are presented and allow the conclusion that this is an excellent procedure when it is well indicated. It means a great saving in shunts and treatments and has become an alternative to shunts in all neurosurgical units.