TY - JOUR T1 - Re-Do endoscopic third ventriculostomy. Retrospective analysis of 13 patients JO - Neurocirugía (English edition) T2 - AU - Linares Torres,Jorge AU - Ros López,Bienvenido AU - Iglesias Moroño,Sara AU - Ros Sanjuán,Ángela AU - Selfa Rodríguez,Antonio AU - Cerro Larrazábal,Laura AU - Casado Ruiz,Julia AU - Arráez Sánchez,Miguel Ángel SN - 25298496 M3 - 10.1016/j.neucie.2021.04.002 DO - 10.1016/j.neucie.2021.04.002 UR - https://revistaneurocirugia.com/en-re-do-endoscopic-third-ventriculostomy-retrospective-articulo-S2529849621000125 AB - ObjetivesIndication for endoscopic third ventriculostomy (ETV) in the treatment for noncommunicating hydrocephalus is widely accepted. There is controversy regarding the indication of a second procedure (re-ETV) when the first has failed. The objective of this work is to revise ETV failures in a series in which re-ETV was performed and to describe the factors related to its prognosis. MethodRetrospective study of pediatric patients with ETV failure treated by re-ETV between 2003 and 2018. Gender, age in first and second ETV, time to failure of first ETV, etiology of hydrocephalus, previous presence of shunt, ETV-SS in the first and second ETV, intraoperative findings, success of the second procedure and follow-up were collected. The ETV-SS result was grouped into high (≥ 80), moderate (50−70) or low (≤ 40) scores. Endoscopic procedure failure was considered clinical worsening or the absence of radiological criteria for improvement (reduction in ventricular size or presence of ETV flow artifact in the floor of third ventricle). ResultsOf 97 ETV carried out in this period, 47 failures were registered, with 13 re-ETV performed. Of these, 8 were classified as successful (61.53%). Re-ETV was successful in 4/4 cases in which etiology was tectal tumor or aqueduct stenosis. In the group with a high ETV-SS score there was a higher rate of success (75%) than in the group with a moderate score (40%). 9 patients presented shunt prior to first ETV and in them, success was 66.6% compared to 50% in the group without prior shunt. All re-ETV were performed without complications. In 11 of the 13 procedures a closed stoma was found and the remaining 2 cases, we found a punctate opening. The mean follow-up after re-ETV was 61.23 months. ConclusionThe selection of patients for re-VET should be cautious. Factors such as age, etiology, and previous shunt (ETV-SS factors) have prognostic influence. However, there are specific factors which indicate favorable prognostic for re-VET such as a longer time to failure of the first procedure, the finding of a closed/punctate stoma or the loss of flow artifact in the follow-up MRI. ER -