Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial

• DOI: 10.3171/jns.2003.98.2.0284
• Publication Date: 2009-05-13T17:55:36Z
• Authors: John R. W. Kestle; James M. Drake; D. Douglas Cochrane; Ruth Milner; Marion L. Walker; Rick Abbott; Frederick A. Boop; _ _
• Keywords: Multicenter trial

Object. Endoscopically assisted ventricular catheter placement has been reported to reduce shunt failure in uncontrolled series. The authors investigated the efficacy of this procedure a prospective multicenter randomized trial. Methods. Children younger than 18 years old who were scheduled for their first ventriculoperitoneal (VP) undergo endoscopic or nonendoscopic insertion catheter. Eligibility and primary outcome (shunt failure) decided blinded fashion. An intention-to-treat analysis was performed. sample size offered 80% power detect 10 15% absolute reduction 1-year rate. studied 393 patients from 16 pediatric neurosurgery centers between May 1996 November 1999. Median patient age at 89 days. baseline characteristics within each group similar: 54% treated with endoscopy male 55% without male; 30% 26% those had myelomeningocele; differential pressure valve used 51% 49% endoscopy; Delta inserted 38% group; Sigma placed 9% 12% endoscopy. surgical time lasted 40 minutes 35 Ventricular catheters, which during surgery thought be situated away choroid plexus, demonstrated it on postoperative imaging 67% undergone 61% placements. incidence 1 year 42% 34% group. not different two groups (log rank = 2.92, p 0.09). Conclusions. Endoscopic initial VP children suffering hydrocephalus did failure.