Endoscopic removal of recurrent colloid cysts Journal Article


Authors: Lara-Reyna, J. J.; Uribe-Cardenas, R.; Perera, I.; Szerlip, N.; Giamouriadis, A.; Savage, N.; Haussner, T.; Souweidane, M. M.
Article Title: Endoscopic removal of recurrent colloid cysts
Abstract: OBJECTIVE Removal of colloid cysts of the third ventricle using a purely endoscopic method has been established as a safe and advantageous technique. It is hypothesized that endoscopic removal in recurrent cases might pose more technical challenges and result in less success. The objective of this study was to assess the feasibility and outcomes of using a purely endoscopic approach for the management of recurrent colloid cysts compared to primary cysts. METHODS A retrospective cohort study was performed on patients who underwent purely endoscopic removal of their colloid cyst. Descriptive statistics were compared for patients undergoing surgery for a recurrent cyst and those for a control cohort undergoing surgery for a primary cyst. Bivariate analysis was conducted using a Fisher’s exact test for categorical variables and Mann-Whitney U-test for continuous variables. RESULTS In total, 121 patients had a primary colloid cyst endoscopically removed and 10 patients had a total of 11 recurrent cysts removed. Recurrence or progression after surgery occurred in 3 (2.5%) cases in the primary cyst group and 2 (18.2%) cases in the recurrent cyst group. Symptomatic presentation during the follow-up period occurred in 6 (54.5%) cases in the recurrent cyst group versus 75 (62%) cases in the primary cyst group (p = 0.749). Two patients (20%) in the recurrent group had a second recurrence in a mean period of 30 months (1 patient at 15 and 1 patient at 45 months). One of these patients required a tertiary endoscopic removal 8 years after the second resection. No immediate postoperative complications or new morbidities were observed after repeat endoscopic surgery. The authors’ findings indicated a nonsignificant trend toward a higher recurrence rate (18.2% vs 2.5%, p = 0.055) and a decreased proportion of complete removal (90.9% vs 81.8%, p = 0.296) in the recurrent cyst group compared to the primary cyst group. However, a significantly higher rate of preoperative hydrocephalus was observed in the primary cyst group compared with the recurrent cyst group (63.6% vs 18.2%, p = 0.007). CONCLUSIONS Purely endoscopic approaches for the removal of recurrent colloid cysts of the third ventricle are feasible and equally safe compared with endoscopic removal of primary cysts. The study’s findings did not show a statistically significant difference in the rate of recurrence between the 2 groups. The proportion of patients with symptomatic cysts on presentation was lower in patients with recurrent cysts than in patients with primary cysts. Due to the high rate of complete removal with negligible morbidity, the authors continue to advocate for an endoscopic removal at the time of cyst recurrence. © AANS 2020, except where prohibited by US copyright law.
Keywords: adolescent; adult; child; school child; aged; surgical technique; major clinical study; comparative study; neuroimaging; nuclear magnetic resonance imaging; recurrence risk; morbidity; cohort analysis; microsurgery; retrospective study; postoperative complication; length of stay; cerebrospinal fluid; endoscopic surgery; reoperation; recurrent disease; craniotomy; brain hemorrhage; hydrocephalus; descriptive research; recurrent; endoscopic; colloid cyst; human; male; female; priority journal; article; preoperative complication; brain interventricular foramen
Journal Title: Journal of Neurosurgery
Volume: 132
Issue: 5
ISSN: 0022-3085
Publisher: American Association of Neurological Surgeons  
Date Published: 2020-05-01
Start Page: 1636
End Page: 1641
Language: English
DOI: 10.3171/2018.12.Jns181859
PUBMED: 30978688
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 June 2020 -- Source: Scopus
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