[Efficiency of neuroendoscopic operations in achieving shunt independency in hydrocephalus with liquor-shunting system dysfunction].

OBJECTIVE: to evaluate the efficiency of endoscopic treatments in achieving shunt independency in patients with hydrocephalus and shunt dysfunction. SUBJECTS AND METHODS: endoscopic treatment was performed in 28 patients (15 males and 13 females) aged 7.0 +/- 1.2 years (0.5-24 years) with hydrocephalus and CSF shunt dysfunction. The interval between the first shunt implantation and endoscopic surgery (the time of shunt dependency) was 43.4 +/- 7.8 months (5-180 months). All operations were made using the universal Gaab neuroendoscopic system (Karl Storz GmbH and Co., Germany). The follow-up lasted 49.4 +/- 6.9 months (6-120 months). RESULTS: All the patients were successfully operated on, without intraoperative complications and deaths being observed. Surgical interventions were as follows: endoscopic ventriculocisternostomy (n=23), endoscopic aqueductoplasty (n=1), and endoscopic cystoventriculocistemrnostomy (n=4). In 24 of the 28 patients, the symptoms of intracranial hypertension regressed completely. CSF shunt reimplantation was required in 3 cases and prolonged external drainage in 1 case of existing ventriculitis. It should be noted that 24 of the 28 patients became shunt-independent; a shunt was removed in 13.