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Review
. 2022 Oct 14:13:467.
doi: 10.25259/SNI_747_2022. eCollection 2022.

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

Damilola Alexander Jesuyajolu  1 , Abdulahi Zubair  1 , Armstrong Kpachi Nicholas  2 , Terngu Moti  1 , Osamagie Ehi Osarobomwen  1 , Israel Anyahaebizi  1 , Charles Okeke  1 , Samuel Olawale Davis  1
Affiliations
Review

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

Damilola Alexander Jesuyajolu et al. Surg Neurol Int. .

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.

Keywords: Endoscopy; Infection; Malfunction; Ventriculostomy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Prisma flow chart
Figure 2:
Figure 2:
Forest plot of studies.
Figure A1
Figure A1
Forest plot depicting only the observational studies.
Figure A2
Figure A2
Forest plot depicting only the high-quality observational studies.
Figure A3
Figure A3
Funnel plot of the observational studies.
See this image and copyright information in PMC

References

    1. Adebayo BO, Kanu OO, Bankole OB, Ojo OA, Adetunmbi B, Morgan E. Early outcome of endoscopic third ventriculostomy with choroid plexus cauterization versus ventriculoperitoneal shunt as primary treatment of hydrocephalus in children with myelomeningocele: A prospective cohort study. Oper Neurosurg (Hagerstown) 2021;21:461–6. - PubMed
    1. Albright AL. Reflections on developing pediatric neurosurgery in Sub-Saharan Africa. J Neurosurg Pediatr. 2016;18:127–38. - PubMed
    1. Appelgren T, Zetterstrand S, Elfversson J, Nilsson D. Long-term outcome after treatment of hydrocephalus in children. Pediatr Neurosurg. 2010;46:221–6. - PubMed
    1. Bryant MJ, McEniery J, Walker DG, Campbell R, Lister B, Sargent P, et al. Preliminary study of shunt related death in paediatric patients. J Clin Neurosci. 2004;11:614–5. - PubMed
    1. Cairo SB, Agyei J, Nyavandu K, Rothstein DH, Kalisya LM. Neurosurgical management of hydrocephalus by a general surgeon in an extremely low resource setting: Initial experience in North Kivu province of eastern democratic republic of Congo. Pediatr Surg Int. 2018;34:467–73. - PubMed

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