Comparative Outcomes of Ventriculoperitoneal Shunting (VPS) vs. Endoscopic Third Ventriculostomy (ETV) in Pediatric Hydrocephalus (<18 years).

Abstract

This retrospective cohort study compares the efficacy and safety of ventriculoperitoneal  shunting (VPS) and endoscopic third ventriculostomy (ETV) in 82 pediatric hydrocephalus  patients. Standardized terminology and outcomes were applied to 52 VPS and 30 ETV  cases. ETV demonstrated significantly higher success rates (70% vs. 54%, p=0.04) and no  infections compared to VPS (33% of failures, p=0.001). Younger age (<1 year) and prior  surgery predicted VPS failure, while non-obstructive etiologies increased ETV failure risk.  ETV outperformed VPS in obstructive hydrocephalus (80% vs. 60% success). These  findings advocate for ETV as first-line therapy for obstructive hydrocephalus and highlight  the need for optimized VPS protocols in infants.