Title |
Efficacy and safety of endoscopic third ventriculostomy and choroid plexus cauterization for infantile hydrocephalus: a systematic review and meta-analysis
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Published in |
Child's Nervous System, September 2016
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DOI | 10.1007/s00381-016-3236-6 |
Pubmed ID | |
Authors |
Alexander G. Weil, Harrison Westwick, Shelly Wang, Naif M. Alotaibi, Lior Elkaim, George M. Ibrahim, Anthony C. Wang, Rojine T. Ariani, Louis Crevier, Bethany Myers, Aria Fallah |
Abstract |
Endoscopic third ventriculostomy/choroid plexus cauterization (ETV/CPC) has gained popularity in its treatment of infantile hydrocephalus over the past decade. In this manuscript, we perform a systematic review and meta-analysis to determine the efficacy and safety of ETV/CPC, and to compare the procedural outcomes between North American and sub-Saharan African cohorts. Systematic review was performed using four electronic databases and bibliographies of relevant articles, with no language or date restrictions. Cohort studies of participants undergoing ETV/CPC that reported outcome were included using MOOSE guidelines. The outcome was time to repeat CSF diversion or death. Forest plots were created for pooled mean and its 95 % CI of outcome and morbidity. Of 78 citations, 11 retrospective reviews (with 524 total participants) were eligible. Efficacy was achieved in 63 % participants at follow-up periods between 6 months and 8 years. Adverse events and mortality was reported in 3.7 and 0.4 % of participants, respectively. Publication bias was detected with respect to efficacy and morbidity of the procedure. A large discrepancy in success was identified between ETV/CPC in six studies from sub-Saharan Africa (71 %), compared to three studies from North America (49 %). The reported success of ETV/CPC for infantile hydrocephalus is higher in sub-Saharan Africa than developed nations. Large long-term prospective multi-center observational studies addressing patient-important outcomes are required to further evaluate the efficacy and safety of this re-emerging procedure. |
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United States | 2 | 50% |
Canada | 1 | 25% |
Unknown | 1 | 25% |
Demographic breakdown
Type | Count | As % |
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Scientists | 2 | 50% |
Science communicators (journalists, bloggers, editors) | 1 | 25% |
Members of the public | 1 | 25% |
Mendeley readers
Geographical breakdown
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United States | 1 | 1% |
Unknown | 69 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 9 | 13% |
Student > Doctoral Student | 8 | 11% |
Student > Master | 7 | 10% |
Professor | 6 | 9% |
Student > Postgraduate | 6 | 9% |
Other | 15 | 21% |
Unknown | 19 | 27% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 29 | 41% |
Neuroscience | 10 | 14% |
Psychology | 2 | 3% |
Economics, Econometrics and Finance | 2 | 3% |
Social Sciences | 2 | 3% |
Other | 5 | 7% |
Unknown | 20 | 29% |