Surgical resection of third ventricle colloid cysts

Preliminary results comparing transcallosal microsurgery with endoscopy

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✓ It is still not determined which is the best surgical option for third ventricle colloid cysts. Since 1990, the authors have used a steerable fiberscope to remove colloid cysts in seven patients and have performed microsurgery via a transcallosal approach in eight patients. The two techniques were compared for operating time, length of hospital stay, incidence of complications, recurrence, and hydrocephalus, and days spent recuperating before return to work to determine if endoscopic removal of colloid cysts is a safe and effective alternative to microsurgery. Statistical analysis was adjusted for age, sex, and presenting symptoms.

Microsurgical cases averaged 206 minutes of operating time whereas endoscopic cases averaged 127 minutes (p = 0.01). For combined days spent in the intensive care unit and on the ward, the patients averaged 9.5 days after microsurgery and 4 days after endoscopy (p = 0.05). Postoperative complications occurred in five of eight patients after microsurgery and in one of seven patients after endoscopy (p = 0.09); complications were transient and primarily related to short-term memory loss. In all patients, preoperative symptoms resolved and the cysts have not recurred. Postoperatively, one patient required a ventriculoperitoneal shunt after microsurgery but all patients were shunt-independent after endoscopy. Patients returned to work an average of 59 days after discharge following microsurgery compared with an average of 26 days after endoscopy (p = 0.05). Compared with transcallosal microsurgery for the removal of colloid cysts, these preliminary results show that a steerable endoscope reduced operating time and that patients spent fewer days in the hospital and returned to work sooner after endoscopy.

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Contributor Notes

Address reprint requests to: Adam I. Lewis, M.D., Department of Neurosurgery, University of Cincinnati College of Medicine, 231 Bethesda Avenue, Cincinnati, Ohio 45267–0515.
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References
  • 1.

    Abernathy CDDavis DHKelly PJ: Treatment of colloid cysts of the third ventricle by stereotaxis microsurgical laser craniotomy. J Neurosurg 70:5255291989Abernathy CD Davis DH Kelly PJ: Treatment of colloid cysts of the third ventricle by stereotaxis microsurgical laser craniotomy. J Neurosurg 70:525–529 1989

    • Search Google Scholar
    • Export Citation
  • 2.

    Antunes JLLouis KMGanti SR: Colloid cysts of the third ventricle. Neurosurgery 7:4504551980Antunes JL Louis KM Ganti SR: Colloid cysts of the third ventricle. Neurosurgery 7:450–455 1980

    • Search Google Scholar
    • Export Citation
  • 3.

    Auer LMHolzer PAscher PWet al: Endoscopic neurosurgery. Acta Neurochir 90:1141988Auer LM Holzer P Ascher PW et al: Endoscopic neurosurgery. Acta Neurochir 90:1–14 1988

    • Search Google Scholar
    • Export Citation
  • 4.

    Bosch DARähn TBacklund EO: Treatment of colloid cysts of the third ventricle by stereotactic aspiration. Surg Neurol 9:15181978Bosch DA Rähn T Backlund EO: Treatment of colloid cysts of the third ventricle by stereotactic aspiration. Surg Neurol 9:15–18 1978

    • Search Google Scholar
    • Export Citation
  • 5.

    Camacho AAbernathey CDKelly PJet al: Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography. Neurosurgery 24:6937001989Camacho A Abernathey CD Kelly PJ et al: Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography. Neurosurgery 24:693–700 1989

    • Search Google Scholar
    • Export Citation
  • 6.

    Chan RCThompson GB: Third ventricular colloid cysts presenting with acute neurological deterioration. Surg Neurol 19:3583621983Chan RC Thompson GB: Third ventricular colloid cysts presenting with acute neurological deterioration. Surg Neurol 19:358–362 1983

    • Search Google Scholar
    • Export Citation
  • 7.

    Cohen ARShucart WA: Ventriculoscopic management of colloid cysts of the third ventricle in Manwaring KHCrone KR (eds): Neuroendoscopy. New York: Mary Ann Liebert1992 Vol 1 pp 109117Cohen AR Shucart WA: Ventriculoscopic management of colloid cysts of the third ventricle in Manwaring KH Crone KR (eds): Neuroendoscopy. New York: Mary Ann Liebert 1992 Vol 1 pp 109–117

    • Search Google Scholar
    • Export Citation
  • 8.

    Fritsch H: Colloid cysts — a review including 19 own cases. Neurosurg Rev 11:1591661988Fritsch H: Colloid cysts — a review including 19 own cases. Neurosurg Rev 11:159–166 1988

    • Search Google Scholar
    • Export Citation
  • 9.

    Kondziolka DLunsford LD: Stereotactic management of colloid cysts: factor predicting success. J Neurosurg 75:45511991Kondziolka D Lunsford LD: Stereotactic management of colloid cysts: factor predicting success. J Neurosurg 75:45–51 1991

    • Search Google Scholar
    • Export Citation
  • 10.

    Little JRMacCarty CS: Colloid cysts of the third ventricle. J Neurosurg 39:2302351974Little JR MacCarty CS: Colloid cysts of the third ventricle. J Neurosurg 39:230–235 1974

    • Search Google Scholar
    • Export Citation
  • 11.

    Mathiesen TGrane PLindquist Cet al: High recurrence rate following aspiration of colloid cysts of the third ventricle. J Neurosurg 78:7487521993Mathiesen T Grane P Lindquist C et al: High recurrence rate following aspiration of colloid cysts of the third ventricle. J Neurosurg 78:748–752 1993

    • Search Google Scholar
    • Export Citation
  • 12.

    Morita AKelly PJ: Resection of intraventricular tumors via a computer-assisted volumetric stereotactic approach. Neurosurgery 32:9209261993Morita A Kelly PJ: Resection of intraventricular tumors via a computer-assisted volumetric stereotactic approach. Neurosurgery 32:920–926 1993

    • Search Google Scholar
    • Export Citation
  • 13.

    Powell MPTorrens MJThomson JLGet al: Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy. Neurosurgery 13:2342371983Powell MP Torrens MJ Thomson JLG et al: Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy. Neurosurgery 13:234–237 1983

    • Search Google Scholar
    • Export Citation
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