Retrospective evaluation of endoscopic treatment in colloid cyst of the third ventricle

Wideochir Inne Tech Maloinwazyjne. 2021 Sep;16(3):604-611. doi: 10.5114/wiitm.2021.103957. Epub 2021 Feb 26.

Abstract

Introduction: Endoscopic methods have gained a well-established position in surgical treatment of colloid cysts of third ventricle. However, the possibility of total tumor removal with this method and the long-term effectiveness of treatment are being questioned.

Aim: Personal twenty years' experience in treatment of third ventricle colloid cysts is presented on the basis of retrospective analysis.

Material and methods: The study group included 58 patients diagnosed by neuroimaging (head CT/MRI) with third ventricle colloid cyst. Post-hospital follow-up ranged from 18 to 42 months. Long-term follow-up head CT/MRI was performed in 39 patients.

Results: The colloid cyst was removed totally in 47 (81%) patients. In 11 cases, the colloid cyst's wall was tightly adherent to the roof of the third ventricle, which limited the radicality of the procedure. Sixteen patients demonstrated memory impairments, 4 patients epilepsy and another 2 akinetic mutism in the direct postoperative course. One patient died as a result of complications unrelated to the procedure. The average hospitalization was 5 days. In the late period after surgery, remission of the most, previously, reported ailments and symptoms has been reported. Surgical treatment for hydrocephalus was needed in 7 patients. In 3 cases cyst recurrence was diagnosed which required reoperation.

Conclusions: The endoscopic methods allow the total removal of a third ventricle colloid cyst in most patients. Leaving a small coagulated fragment of the cyst rarely results in its recurrence. This method results in effective treatment with a low complications rate, shortens hospitalization time and brings the patient a high level of satisfaction with a quick recovery.

Keywords: colloid cyst; long-term results; neuroendoscopy; third ventricle.