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. 2025 Jun 1:5:104291.
doi: 10.1016/j.bas.2025.104291. eCollection 2025.

Complications and risk factors of endoscopic third ventriculostomy: A 10-year single-centre study and systematic literature review

Einar Naveen Møen  1 , Christian André Helland  2 , Rupavathana Mahesparan  1   2
Affiliations

Complications and risk factors of endoscopic third ventriculostomy: A 10-year single-centre study and systematic literature review

Einar Naveen Møen et al. Brain Spine. .

Abstract

Introduction: Endoscopic third ventriculostomy is considered a safe and low-risk treatment of obstructive hydrocephalus. No systematic review has been conducted recently to establish benchmarks for success and complication rates. This knowledge gap makes it difficult to evaluate local institutional performance against international results.

Research question: What are the results of endoscopic third ventriculostomy for obstructive hydrocephalus in the literature, and how does it compare to the results of our medium-sized neurosurgical center?

Material and methods: We performed a retrospective case series of patients treated at the Department of Neurosurgery, Haukeland University Hospital, from January 1, 2013, to December 31, 2023. A systematic review was performed in accordance with the PRISMA guidelines.

Results: Our case series consisted of 127 patients in a mixed-age cohort (mean: 37.3, range: 0-86) treated with endoscopic third ventriculostomy for hydrocephalus the last ten years. Previous shunting and neurosurgery were identified as risk factors for endoscopic third ventriculoscopy failure. In our systematic review, we found 64 reports with a total of 8409 patients eligible for inclusion. A higher success rate (78.7%) and complication rate (21.3%) were found in our patient material compared to the findings in our systematic review (respectively 73.4% and 11.6%). All complications in our material were transient and did not cause any permanent morbidity.

Discussion and conclusions: Endoscopic third ventriculostomy has a favorable safety profile with high success rates in the treatment of obstructive hydrocephalus. Results from our systematic review can be used for internal audits at other neurosurgical centers.

Keywords: Case series; Endoscopic third ventriculostomy; Hydrocephalus; Quality assurance; Surgical outcomes; Systematic review.

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Conflict of interest statement

The authors whose names are listed below certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Survival in Endoscopic Third Ventriculostomy For Patients Without Prior Shunting Fig. 1. This figure shows the survival of endoscopic third ventriculostomy in patients with no prior shunting (n = 109).
Fig. 2
Fig. 2
Flow Diagram for Systematic Reviews Fig. 2. This figure shows the process of identifying reports eligible for inclusion in our systematic review.
See this image and copyright information in PMC

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