{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T04:06:54Z","timestamp":1748664414750,"version":"3.41.0"},"reference-count":36,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nThe objective of this research article is to compare endoscopic treatment versus shunting procedures for failed endoscopic third ventriculostomies (ETVs) in pediatric patients with hydrocephalus.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nWe did a systematic review based on preferred reporting items for systematic reviews and meta-analyses guidelines on Studies involving pediatric patients (aged 0\u201318 years) diagnosed with hydrocephalus, reporting on the use of repeat ETV (Re-ETV) or Ventriculoperitoneal shunting (VPS) as a treatment option following failed ETV. Comparative studies, including randomized controlled trials, cohort studies, and any prospective studies, are included. Studies published in the English language conducted between 2001 and 2023 are included.<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nForty articles were selected for full-text review. Out of which nine articles that clearly addressed the topic of Re-ETV and\/or VPS placement after failure of primary ETV were deemed suitable for analysis. A data set of 663 patients was analyzed. Re-ETV was done in 220 patients (33.18%) and VPS Placement was done in 443 patients (66.81%). The primary ETV failure rates ranged from 16.6 to 60.89%. There was a higher failure rate of Re-ETV (74.98%) compared to VPS (22.26%) indicating that VPS is generally more successful as a secondary intervention. The presence of hemorrhage during primary ETV suggested more benefit from VPS placement rather than Re-ETV (P<\/jats:italic> < 0.05).<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nOur systematic review suggests that VPS placement is the more prevalent choice after primary ETV failure, likely due to its higher overall success rate and the nature of complications. The wide variability in failure rates and follow-up durations suggests that treatment outcomes can differ greatly between patients and studies. Decisions regarding secondary interventions should be individualized, considering patient-specific factors such as age, complications, and timing of intervention.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1111_2024","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T09:52:49Z","timestamp":1748598769000},"page":"205","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Re-endoscopic third ventriculostomy versus ventriculoperitoneal shunting in failed endoscopic third ventriculostomy in pediatric patients with hydrocephalus: A systematic review"],"prefix":"10.25259","volume":"16","author":[{"given":"Ikhlas","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usama","family":"Choudry","sequence":"additional","affiliation":[{"name":"Department Neurosurgery, Queen\u2019s Medical Centre, Nottingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim Rizwan","family":"Nathani","sequence":"additional","affiliation":[{"name":"Department Neurosurgery, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul","family":"Basit","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saad","family":"Akhtar Khan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roua","family":"Nasir","sequence":"additional","affiliation":[{"name":"Department Neurological Surgery, Aga Khan University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minza","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Noor","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Saad","family":"Pasha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aabiya","family":"Arif","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ziauddin University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naveed Zaman","family":"Akhunzada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rehman Medical Institute, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oswin","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sohail Trust Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"10.25259\/SNI_1111_2024\/ref-1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.3171\/2022.3.PEDS224","article-title":"Endoscopic third ventriculostomy revision after failure of initial endoscopic 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