Neuroendoscopic colloid cyst resection: a case cohort with follow-up and patient satisfaction

World Neurosurg. 2014 Mar-Apr;81(3-4):584-93. doi: 10.1016/j.wneu.2013.12.006. Epub 2013 Dec 22.

Abstract

Objective: To analyze the safety and efficacy of neuroendoscopic colloid cyst resection and to assess patient satisfaction.

Methods: A retrospective analysis of a single surgeon's experience with neuroendoscopic resection of colloid cysts was performed. Surgeries performed in 56 patients were reviewed. Surgeries involved an anterolateral neuroendoscopic technique. Patients were followed postoperatively for an average of 14.9 months. Patients were also interviewed regarding their preoperative symptoms, resolution of symptoms postoperatively, and their degree of satisfaction.

Results: The median operative time was 82 minutes, and the median duration of hospital stay was 5 days. During surgery, the ventricles were explored for residual cyst wall or cyst content, and none were encountered. On immediate postoperative imaging, cyst recurrence was not noted for any patient, and only 1 patient has had evidence of recurrence on long-term follow-up. Various preoperative symptoms were described by patients; depending on the specific symptoms, 70%-100% resolution of symptoms was shown after surgery. Along with clinical follow-up, patients were interviewed regarding their perception of surgery and recovery. Of the patients contacted, 100% reported satisfaction with the surgery, and 91% noted satisfaction with their recovery. Reported complications included memory loss, infection, deep vein thrombosis, and postoperative hematoma. There were 2 perioperative deaths (3.5%) related to surgery.

Conclusions: Neuroendoscopic colloid cyst resection can reliably achieve complete lesion removal with short operative times. In addition, there is a high level of reported patient satisfaction. To our knowledge, this is the largest case series of neuroendoscopic colloid cyst resections from a single surgeon.

Keywords: Colloid cyst; Endoscopic third ventriculostomy; Memory loss; Neuroendoscopy; Neuronavigation; Patient satisfaction; Ventriculoperitoneal shunt.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cautery / adverse effects
  • Cautery / methods
  • Colloid Cysts / pathology*
  • Colloid Cysts / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / pathology
  • Hydrocephalus / surgery
  • Length of Stay
  • Magnetic Resonance Imaging
  • Male
  • Memory Disorders / etiology
  • Middle Aged
  • Neuroendoscopy / adverse effects
  • Neuroendoscopy / methods*
  • Operative Time
  • Patient Satisfaction*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Third Ventricle / pathology
  • Third Ventricle / surgery
  • Treatment Outcome
  • Ventriculoperitoneal Shunt / adverse effects
  • Ventriculoperitoneal Shunt / methods*
  • Young Adult