Abstract
This project was undertaken to examine the health resource implications of performing
endoscopic third ventriculostomy as an alternative to CSF shunting in appropriate
patients. We carried out a retrospective study of case records and X-rays of patients
shunted de novo at the INS, Glasgow for the two year period 1990 - 1991.We identified all those patients
who would have been suitable for endoscopic third ventriculostomy and examined the
shunt complications and extra days in hospital required by these patients. A total
of 150 new shunts was inserted during the two year period. Of these, 23 patients (15%)
were judged suitable for endoscopic third ventriculostomy as an alternative to CSF
shunting. Eight out of 23 patients required a total of 29 repeat operations and an
extra 230 days in hospital due to shunt complications. Assuming an 80% success (shunt
free) rate for endoscopic third ventriculostomy, we calculate that 9 operations and
74 bed days per year could be saved by using this technique. We conclude that in units
undertaking a large number of CSF shunt insertions, investment in neuroendoscopic
equipment, training, and expertise has the potential to release significant resources
for other uses.
Key words
Hydrocephalus - Third ventriculostomy - Shunt complications - Health care resources
