Efficacy and safety of endoscopic third ventriculostomy and choroid plexus cauterization for infantile hydrocephalus: a systematic review and meta-analysis
| Autor: | Lior M Elkaim, Anthony C. Wang, Aria Fallah, Harrison J. Westwick, Naif M. Alotaibi, Bethany A. Myers, George M. Ibrahim, Shelly Wang, Rojine Ariani, Alexander G. Weil, Louis Crevier |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics medicine.medical_treatment Ventriculostomy 03 medical and health sciences 0302 clinical medicine medicine Forest plot Humans Third Ventricle business.industry Infant Newborn Endoscopic third ventriculostomy Infant General Medicine Publication bias medicine.disease Surgery Hydrocephalus 030220 oncology & carcinogenesis Meta-analysis Pediatrics Perinatology and Child Health Cauterization Female Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Child's Nervous System. 32:2119-2131 |
| ISSN: | 1433-0350 0256-7040 |
| Popis: | Endoscopic third ventriculostomy/choroid plexus cauterization (ETV/CPC) has gained popularity in its treatment of infantile hydrocephalus over the past decade. In this manuscript, we perform a systematic review and meta-analysis to determine the efficacy and safety of ETV/CPC, and to compare the procedural outcomes between North American and sub-Saharan African cohorts. Systematic review was performed using four electronic databases and bibliographies of relevant articles, with no language or date restrictions. Cohort studies of participants undergoing ETV/CPC that reported outcome were included using MOOSE guidelines. The outcome was time to repeat CSF diversion or death. Forest plots were created for pooled mean and its 95 % CI of outcome and morbidity. Of 78 citations, 11 retrospective reviews (with 524 total participants) were eligible. Efficacy was achieved in 63 % participants at follow-up periods between 6 months and 8 years. Adverse events and mortality was reported in 3.7 and 0.4 % of participants, respectively. Publication bias was detected with respect to efficacy and morbidity of the procedure. A large discrepancy in success was identified between ETV/CPC in six studies from sub-Saharan Africa (71 %), compared to three studies from North America (49 %). The reported success of ETV/CPC for infantile hydrocephalus is higher in sub-Saharan Africa than developed nations. Large long-term prospective multi-center observational studies addressing patient-important outcomes are required to further evaluate the efficacy and safety of this re-emerging procedure. |
| Databáze: | OpenAIRE |
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