Department of Pediatric Neurosurgery, Vila da Serra Hospital, Alameda Oscar Niemeyer, 499, Nova Lima, Minas Gerais, 34000-000, Brazil.
Neurosurg Rev. 2021 Oct;44(5):2727-2734. doi: 10.1007/s10143-020-01461-6. Epub 2021 Jan 3.
The endoscopic third ventriculostomy (ETV) success score (ETVSS) was developed to predict the success rate of ETV at 6 months. In this study, the authors assessed the performance of this score for > 6 months, i.e., at 12 months, and provided external validation in Brazilian children. All children undergoing first ETV (without choroid plexus cauterization) at a Brazilian single institution for > 20 years were included in the study. The ETVSS was retrospectively calculated for each patient and compared with the actual success of the procedure observed at 6 and 12 months after the procedure. A total of 313 eligible children underwent initial ETV, 34.18% of whom had undergone shunt placement before ETV. The most common etiologies were aqueductal stenosis (45%) and non-tectal brain tumors (20.8%). ETV was successful at 6 months in 229 patients (73.16%) compared with the 61.3% predicted by the ETVSS. The overall actual success rate observed at 1 year after ETV was 65.1% (204 patients). The area under the receiver operating characteristic curve was 0.660 at 6 months and 0.668 at 1 year, which suggested a tendency for the ETVSS to underestimate the actual success rate of ETV at both timepoints. The ETVSS showed good success prediction in accordance with the actual ETV success rate and proved to be useful during the decision-making process of ETV.
内镜第三脑室造瘘术（ETV）成功率评分（ETVSS）旨在预测 ETV 在 6 个月时的成功率。本研究评估了该评分超过 6 个月（即 12 个月）的性能，并在巴西儿童中进行了外部验证。本研究纳入了 20 多年来在巴西一家单机构接受首次 ETV（未行脉络丛烧灼）的所有儿童。回顾性计算每位患者的 ETVSS，并将其与术后 6 个月和 12 个月观察到的手术实际成功率进行比较。共有 313 名符合条件的儿童接受了初始 ETV，其中 34.18%在 ETV 前曾行分流术。最常见的病因是导水管狭窄（45%）和非脑室内脑肿瘤（20.8%）。229 名患者（73.16%）在 6 个月时 ETV 成功，而 ETVSS 预测的成功率为 61.3%。ETV 后 1 年的总体实际成功率为 65.1%（204 名患者）。6 个月和 1 年后的受试者工作特征曲线下面积分别为 0.660 和 0.668，表明 ETVSS 在这两个时间点都存在低估 ETV 实际成功率的趋势。ETVSS 与实际 ETV 成功率的成功预测相符，并且在 ETV 决策过程中证明是有用的。
