Colloid cyst resection

Colloid cyst resection

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 complication3).

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).


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Ibáñez-Botella G, Narváez IF, Pugliese B, Ros B, Arráez MA. Endoscopic resection of third ventricle colloid cysts using an ultrasonic aspirator. Neurosurg Rev. 2024 Mar 16;47(1):117. doi: 10.1007/s10143-024-02293-4. PMID: 38491331.

Sayehmiri F, Starke RM, Eichberg DG, Ghanikolahloo M, Rahmatian A, Fathi M, Vakili K, Ebrahimzadeh K, Rezaei O, Samadian M, Mousavinejad SA, Maloumeh EN, Tavasol HH, Sharifi G. Comparison of microscopic and endoscopic resection of third-ventricular colloid cysts: A systematic review and meta-analysis. Clin Neurol Neurosurg. 2022 Apr;215:107179. doi: 10.1016/j.clineuro.2022.107179. Epub 2022 Feb 18. PMID: 35220036.

Heller RS, Heilman CB. Colloid Cysts: Evolution of Surgical Approach Preference and Management of Recurrent Cysts. Oper Neurosurg (Hagerstown). 2019 Apr 10. pii: opz059. doi: 10.1093/ons/opz059. [Epub ahead of print] PubMed PMID: 31220314.

Sheikh AB, Mendelson ZS, Liu JK. Endoscopic versus microsurgical resection of colloid cysts: a systematic review and meta-analysis of 1,278 patients. World Neurosurg. 2014 Dec;82(6):1187-97. doi: 10.1016/j.wneu.2014.06.024. Epub 2014 Jun 18. Review. PubMed PMID: 24952223.

Connolly ID, Johnson E, Lamsam L, Veeravagu A, Ratliff J, Li G. Microsurgical vs. Endoscopic Excision of Colloid Cysts: An Analysis of Complications and Costs Using a Longitudinal Administrative Database. Front Neurol. 2017 Jun 9;8:259. doi: 10.3389/fneur.2017.00259. eCollection 2017. PubMed PMID: 28649225; PubMed Central PMCID: PMC5465269.