• Endoscopic resection of third ventricle colloid cysts using an ultrasonic aspirator
• Interhemispheric Transcallosal Resection of Large Colloid Cyst Through Nondilated Foramen with Use of Microblade Retractor: 2-Dimensional Operative Video
• Trascallosal bilateral transforaminal resection of a solid partially calcified colloid cyst: 2D operative video
• Isolated entrapment of the lateral ventricle after neuroendoscopic resection of colloid cysts: single – center experience and management
• Extensive cerebral venous thrombosis after resection of third ventricle colloid cyst
• Full-endoscopic removal of third ventricular colloid cysts: technique, results, and limitations
• Endoscopic trans-septal interforniceal approach for excision of colloid cysts of the third ventricle using the rotational technique
• Exoscope-Assisted, Channel-Based Approach for Resection of 3rd Ventricular Colloid Cyst: 2-Dimensional Operative Video

The colloid cyst treatments has evolved rapidly since the first successful excision of a colloid cyst via the transcortical transventricular approach by Walter Dandy in 1921 ¹⁾. This was followed closely by a transcallosal approach by Greenwood in 1949 ²⁾.

There is a lack of consensus regarding the preferred surgical strategy for colloid cyst resection; the technique with the optimal rates of remission, recurrence, mortality, and complications is debatable.

The ultrasonic aspirator can be used safely and effectively for the resection of colloid cysts of the third ventricle, achieving high rates of complete resection with minimal postoperative complications ³⁾.

Microsurgical resection of third ventricle colloid cysts was associated with a higher rate of GTR and a lower rate of recurrence, while there was a lower rate of postoperative complications, duration of surgery, and shorter hospitalization period in the endoscopic group ⁴⁾.

Surgical resection of recurrent colloid cysts should focus on complete removal of the cyst wall to minimize the chance of recurrence. Microsurgery has been shown to provide the highest success rates for cyst wall resection and lowest rates of recurrence and is therefore recommended for patients undergoing surgery for primary and recurrent colloid cysts ⁵⁾.

In a metaanalysis and systematic review microsurgical resection of colloid cysts is associated with a higher rate of complete resection, lower rate of recurrence, and fewer reoperations than with endoscopic removal. However, the rate of morbidity is higher with microsurgery than with endoscopy

This meta-analysis of 1278 patients comparing endoscopic and various microsurgical techniques found that the microsurgical group had a significantly greater extent of resection (96.8% vs. 58.2%), lower rates of recurrence (1.48% vs. 3.91%), and lower rates of reoperation than the endoscopic group (0.38% vs. 3.0%). Both groups had similar rates of mortality (1.4% vs. 0.6%) and shunt dependency (6.2% vs. 3.9%). Overall, the complication rate was lower in the endoscopic group than in the microsurgical group (10.5% vs. 16.3%). Within the microsurgery group, the transcallosal approach had a lower overall morbidity rate (14.4%) than the transcortical approach (24.5%) ⁶⁾.

An analysis of administrative claims data revealed few differences in surgical complications following colloid cyst excision via microsurgical and endoscopic approaches. Post-operative seizures and thirty-day readmissions were seen at higher frequency in patients who underwent microsurgical resection. Despite similar complication profiles, patients undergoing microsurgical excision experienced higher index admission costs and 90-day aggregated costs suggesting that complications may have been more severe in this group ⁷⁾.

Colloid cyst endoscopy.

Colloid cyst resection complications