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Child's Nervous System

, Volume 35, Issue 5, pp 789–794 | Cite as

Endoscopic third ventriculostomy prior to resection of posterior fossa tumors in children

  • Fabio Frisoli
  • Michael Kakareka
  • Kristina A. Cole
  • Angela J Waanders
  • Phillip B. Storm
  • Shih-Shan LangEmail author
Original Article
  • 34 Downloads

Abstract

Objective

Hydrocephalus is a common presenting symptom of pediatric posterior fossa tumors and often requires permanent cerebrospinal fluid diversion even after resection. Endoscopic third ventriculostomy (ETV) is a well-established treatment of obstructive hydrocephalus in children. The objective of this study is to demonstrate that ETV prior to posterior fossa tumor resection decreases the rate of postoperative ventriculoperitonal shunt (VPS) placement.

Methods

We performed a retrospective analysis of patients who presented with hydrocephalus and underwent posterior fossa tumor resection between 2005 and 2016 excluding pineal and tectal tumors. The rate of postoperative VPS placement was compared in patients who underwent resection and had a VPS placed perioperatively (historical controls) with patients who underwent ETV prior to resection. The two groups were matched for demographics, tumor histology, and tumor location. We also performed a literature review of prior studies that examined the role of ETV in pediatric posterior fossa tumors.

Results

Thirty-six patients in the control group were compared to 38 patients in our study. The patients were matched across all variables (age, gender, tumor histology, and tumor locations). The rate of postoperative VPS placement was 31% in the control group compared to 16% in the ETV group. No complications were encountered during ETV.

Conclusions

Endoscopic third ventriculostomy prior to posterior fossa tumor resection in children appears to decrease the rate of postoperative VPS placement. Given its efficacy and safety, ETV should be considered prior to tumor resection in these patients.

Keywords

Endoscopic third ventriculostomy Posterior fossa tumor Pediatrics Ventriculoperitoneal shunt 

Abbreviations

ETV

Endoscopic third ventriculostomy

CSF

Cerebrospinal fluid

VPS

Ventriculoperitoneal shunt

EVD

External ventricular drainage

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Fabio Frisoli
    • 1
    • 2
  • Michael Kakareka
    • 2
    • 3
  • Kristina A. Cole
    • 4
  • Angela J Waanders
    • 5
  • Phillip B. Storm
    • 2
    • 6
  • Shih-Shan Lang
    • 2
    • 6
    Email author
  1. 1.Department of NeurosurgeryNew York University School of MedicineNew York CityUSA
  2. 2.Division of Neurosurgery, Children’s Hospital of Philadelphia, Department of Neurosurgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of NeurosurgeryPhiladelphia College of Osteopathic MedicinePhiladelphiaUSA
  4. 4.Division of Oncology, Children’s Hospital of Philadelphia, Department of Pediatrics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.Division of Hematology, Oncology, and Stem Cell Transplant, Ann & Robert H Lurie Children’s Hospital of Chicago, Department of PediatricsFeinberg School of Medicine Northwestern UniversityChicagoUSA
  6. 6.Center for Data Driven Discovery in BiomedicineChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

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