Abstract
Background and Objectives: To assess the outcome of Endoscopic Third Ventriculostomy (ETV) versus Ventriculoperitoneal Shunt (VPS) in Obstructive Hydrocephalus in terms of infections, foreign bodies, cost-effectiveness, and length of hospital stay.
 Materials and Methods: It was a Randomized Controlled Trial study, in which 30 patients with Obstructive Hydrocephalus were divided into two groups one was treated with (ETV) and the other was treated with VP Shunt and the patients were followed up for 1 year.
 Results: Patients were divided into 2 groups, 15 were treated with ETV, and 15 were treated with VP Shunt. Length of stay for VP shunt was 7 ± 0.85 days and for ETV mean stay was 2.93 ± 1.1 days. The complication was observed in 4 (26.7%) treated with VP Shunt and in 3 (20%) patients with Endoscopic Third Ventriculostomy. In ETV, 3 (20%) patients had recurrence whereas in VP shunt in 1 (6.67%) had an infection and in 3 (20%) patients had recurrence (upper-end blockage) and the overall success rate was 76% in both the procedures and in VP Shunt 73.3% and ETV 80%. Overall there were no complications found in 23 (76.6%) patients, in 3 (10%) patient’s complications were found at 1st month, in 3 (10%) complications were observed at 3rd month, and in 1(3.3%) complication was recorded at 6th month.
 Conclusion: ETV was found better in terms of length of hospital stay, cost-effectiveness as well as minimal complication rate as compared to VP shunt.
Highlights
Hydrocephalus is described as acute or chronic dilatation of all the ventricles either due to overproduction of Cerebrospinal Fluid (CSF) or a decrease in absorption
The average cost of each patient treated with Endoscopic Third Ventriculostomy (ETV) was around 17000 rupees as the patient was admitted for an average of 3 days and it was 52000 rupees for the patients treated with VP shunt as the patient was admitted for an average of 7 days. The ratio between these two is 1:3 which indicates that ETV is a much better choice than VP shunt in terms of cost-effectiveness as shown in (Table 4)
Either to go for VP Shunt, which has been a workhorse method for a neurosurgeon, or too apt for a contemporary method of treatment i.e., endoscopic third ventriculostomy (ETV)
Summary
Hydrocephalus is described as acute or chronic dilatation of all the ventricles either due to overproduction of Cerebrospinal Fluid (CSF) or a decrease in absorption. Endoscopic third ventriculostomy (ETV) is an alternate procedure for Obstructive Hydrocephalus.[8] This treatment is non-invasive. It prevents infection, shunt dependency, shunt malfunction, and the cost of a shunt. The research was done to assess the longterm consequences of Endoscopic Third Ventriculostomy in patients who had previously had shunt insertion for obstructive hydrocephalus. Endoscopic Third Ventriculostomy is safe and effective for treating shunt malfunction in individuals with obstructive hydrocephalus; according to a one-year follow-up.7 12-month follow-up research confirmed the same outcomes.[7]. If surgeons take proper sterilization precautions this infection rate can be decreased from 16% to 3%.13 two groups, one receiving ETV and the other receiving VP Shunt, and the patients were followed up for a year. All the patients with Obstructive Hydrocephalus either due to congenital or acquired (neoplastic), patients with ages between 16 to 60 years, and both male and female patients with no sex predilection were included in this study
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