Removal of colloid cysts of the third ventricle using a purely endoscopic method has been established as a safe and advantageous technique. It is hypothesized that endoscopic removal in recurrent cases might pose more technical challenges and result in less success. The objective of this study was to assess the feasibility and outcomes of using a purely endoscopic approach for the management of recurrent colloid cysts compared to primary cysts.
A retrospective cohort study was performed on patients who underwent purely endoscopic removal of their colloid cyst. Descriptive statistics were compared for patients undergoing surgery for a recurrent cyst and those for a control cohort undergoing surgery for a primary cyst. Bivariate analysis was conducted using a Fisher’s exact test for categorical variables and Mann-Whitney U-test for continuous variables.
In total, 121 patients had a primary colloid cyst endoscopically removed and 10 patients had a total of 11 recurrent cysts removed. Recurrence or progression after surgery occurred in 3 (2.5%) cases in the primary cyst group and 2 (18.2%) cases in the recurrent cyst group. Symptomatic presentation during the follow-up period occurred in 6 (54.5%) cases in the recurrent cyst group versus 75 (62%) cases in the primary cyst group (p = 0.749). Two patients (20%) in the recurrent group had a second recurrence in a mean period of 30 months (1 patient at 15 and 1 patient at 45 months). One of these patients required a tertiary endoscopic removal 8 years after the second resection. No immediate postoperative complications or new morbidities were observed after repeat endoscopic surgery. The authors’ findings indicated a nonsignificant trend toward a higher recurrence rate (18.2% vs 2.5%, p = 0.055) and a decreased proportion of complete removal (90.9% vs 81.8%, p = 0.296) in the recurrent cyst group compared to the primary cyst group. However, a significantly higher rate of preoperative hydrocephalus was observed in the primary cyst group compared with the recurrent cyst group (63.6% vs 18.2%, p = 0.007).
Purely endoscopic approaches for the removal of recurrent colloid cysts of the third ventricle are feasible and equally safe compared with endoscopic removal of primary cysts. The study’s findings did not show a statistically significant difference in the rate of recurrence between the 2 groups. The proportion of patients with symptomatic cysts on presentation was lower in patients with recurrent cysts than in patients with primary cysts. Due to the high rate of complete removal with negligible morbidity, the authors continue to advocate for an endoscopic removal at the time of cyst recurrence.
BirskiMBirskaJPaczkowskiDFurtakJRusinekMRudasM: Combination of neuroendoscopic and stereotactic procedures for total resection of colloid cysts with favorable neurological and cognitive outcomes. World Neurosurg85:205–2142016
BirskiM, BirskaJ, PaczkowskiD, FurtakJ, RusinekM, RudasM, : Combination of neuroendoscopic and stereotactic procedures for total resection of colloid cysts with favorable neurological and cognitive outcomes. 85:205–214, 20162634856410.1016/j.wneu.2015.08.080)| false
BoogaartsHD, DecqP, GrotenhuisJA, Le GuérinelC, NseirR, JarrayaB, : Long-term results of the neuroendoscopic management of colloid cysts of the third ventricle: a series of 90 cases. 68:179–187, 20112115076310.1227/NEU.0b013e3181ffae71)| false
ChibbaroSChampeauxCPoczosPCardarelliMDi RoccoFIaccarinoC: Anterior trans-frontal endoscopic management of colloid cyst: an effective, safe, and elegant way of treatment. Case series and technical note from a multicenter prospective study. Neurosurg Rev37:235–2412014
ChibbaroS, ChampeauxC, PoczosP, CardarelliM, Di RoccoF, IaccarinoC, : Anterior trans-frontal endoscopic management of colloid cyst: an effective, safe, and elegant way of treatment. Case series and technical note from a multicenter prospective study. 37:235–241, 201410.1007/s10143-013-0508-424352893)| false
HarrisPATaylorRThielkeRPayneJGonzalezNCondeJG: Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform42:377–3812009
HarrisPA, TaylorR, ThielkeR, PayneJ, GonzalezN, CondeJG: Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. 42:377–381, 20091892968610.1016/j.jbi.2008.08.010)| false
HellwigD, BauerBL, SchulteM, GatscherS, RiegelT, BertalanffyH: Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade. 52:525–533, 200310.1227/01.NEU.0000047671.27057.5512590676)| false
HoffmanCE, SavageNJ, SouweidaneMM: The significance of cyst remnants after endoscopic colloid cyst resection: a retrospective clinical case series. 73:233–239, 20132362441110.1227/01.neu.0000430300.10338.71)| false
HornEM, Feiz-ErfanI, BristolRE, LekovicGP, GoslarPW, SmithKA, : Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection. 60:613–620, 200710.1227/01.NEU.0000255409.61398.EA17415197)| false
LongattiP, GodanoU, GangemiM, DelitalaA, MoraceE, GenitoriL, : Cooperative study by the Italian neuroendoscopy group on the treatment of 61 colloid cysts. 22:1263–1267, 200610.1007/s00381-006-0105-8)| false
MishraSChandraPSSuriARajenderKSharmaBSMahapatraAK: Endoscopic management of third ventricular colloid cysts: eight years’ institutional experience and description of a new technique. Neurol India58:412–4172010
MishraS, ChandraPS, SuriA, RajenderK, SharmaBS, MahapatraAK: Endoscopic management of third ventricular colloid cysts: eight years’ institutional experience and description of a new technique. 58:412–417, 201010.4103/0028-3886.6622220644270)| false
O’HayonBB, DrakeJM, OssipMG, TuliS, ClarkeM: Frontal and occipital horn ratio: a linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus. 29:245–249, 1998991754110.1159/000028730)| false
SribnickEA, DadashevVY, MillerBA, HawkinsS, HadjipanayisCG: Neuroendoscopic colloid cyst resection: a case cohort with follow-up and patient satisfaction. 81:584–593, 201410.1016/j.wneu.2013.12.00624368424)| false