Endoscopic technique in the treatment of patients with colloid cysts of the third ventricle. Report based on over a decade of experience

Abstract Background and purpose The aim of the work was a retrospective analysis of the efficiency of endoscopic treatment of patients with colloid cysts of the third ventricle. Material and methods The analysis covered 17 patients. There were 19 operations in total. The follow-up period ranged from 21 to 130 months. The effectiveness of the method was evaluated by comparing neurological condition and magnetic resonance imaging (MRI) before and after treatment. Results The mean duration of surgery was 81 minutes. The cyst was removed completely in 8 patients, subtotally in 5, partially in 3, and in 1 case a biopsy was performed. No persistent intra- or postoperative complications or deaths occurred. Immediately after the operation symptoms withdrew completely in 8 patients and partially in 9. In the long term follow-up period, all symptoms receded completely in 11 patients and a further 6 patients showed partial improvement. MRI revealed the absence of the cyst in 8 patients, in 2 patients the tumor was smaller in size and in a further 7 patients some small parts of the walls of the cyst were present. The width of the ventricle system returned to its normal size in 8 patients, decreased in 8 patients and in 1 case remained at its initial size. In 2 patients temporary postoperative complications occurred. The average hospitalization time was 9 days. Conclusions Recurrences of colloidal cysts after subtotal and partial removal do not occur very often, and the time of the recurrence may either be very long or it may not happen at all. Although we recommend complete removal of the cyst, this should not be pursued at the cost of incurring operative complications.