• Chuzhong Li, Songbai Gui, and Yazhuo Zhang.
• a Department of Neurosurgery , Beijing Neurosurgical Institute , Beijing Tiantan Hospital affiliated to Capital Medical University , Beijing Institute for Brain Disorders Brain Tumor Center, China National Clinical Research Center for Neurological Diseases.
• Int. J. Neurosci. 2017 Jul 12: 1-30.

PurposeEndoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt placement are two surgical options used for treatment of non-communicating hydrocephalus. The purpose of this study was to compare the efficiency and safety of these techniques in pediatric patients.Materials And MethodsAn extensive literature review regarding the clinical outcome, safety, and efficiency of ETV and shunting in treatment of hydrocephalus was conducted in Medline, PubMed, Cochrane, and Google Scholar databases up to November 27th, 2015. Patient demographics, ETV and shunting success and failure rates were extracted.ResultsA total of 7 two-arm studies were included for quantitative analysis and 25 single-arm studies were included for systematic review. The two-arm studies recruited a total of 6995 patients: 1046 in the ETV group and 5949 in the shunt group. The pooled results showed that the 1 year success rate of ETV and shunt-placement procedure were similar (pooled RR = 0.870, 95% CI = 0.680 to 1.112, P = 0.266). The failure rate in the ETV treatment group was 0.9 times higher than in the shunt group; however, the results did not reach statistical significance (pooled RR = 0.893, 95% CI = 0.576 to 1.383, P = 0.611).ConclusionsBoth ETV and shunts are associated with similar 1 year success and failure rates. Therefore, there are no current indications to recommend one mode of treatment over the other. Future studies designed to assess the effectiveness of ETV and shunt procedures depending on patient's age and etiology are warranted.

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