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Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts

Published online by Cambridge University Press:  02 December 2014

Ron T. Grondin ,
Walter Hader ,
M. Elizabeth MacRae  and
Mark G. Hamilton
Ron T. Grondin
Affiliation:
Division of Neurosurgery, Alberta Children's Hospital, Calgary, Alberta, Canada
Walter Hader
Affiliation:
Department of Clinical Neurosciences, Division of Neurosurgery, University of Calgary, Foothills Hospital and Alberta Children's Hospital
M. Elizabeth MacRae
Affiliation:
Division of Neurosurgery, Alberta Children's Hospital, Calgary, Alberta, Canada
Mark G. Hamilton
Affiliation:
Division of Neurosurgery, Alberta Children's Hospital, Calgary, Alberta, Canada
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Abstract

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Objective:

Endoscopic resection of colloid cysts has been performed as an alternative to microsurgical resection and stereotactic aspiration since 1982. To date, there are limited published studies comparing these procedures. In this study, we present the largest series of endoscopic resections published to date and compare outcomes to a cohort of microsurgical resections performed at the same institution.

Methods:

A retrospective chart review was conducted for all patients in the Calgary Health Region undergoing resection of a colloid cyst between 1991 and 2004. Comparison was made between patients treated with endoscopic resection versus microsurgical resection.

Results:

Twenty-five endoscopic and nine microsurgical procedures were performed. Complete resection was achieved in 24 of 25 procedures in the Endoscopic group, compared with all 9 procedures in the Microsurgical group. Patients in the Endoscopic group had a reduced operative time (mean 104 minutes versus 217 minutes) and reduced length of stay (3.8 days versus 8.4 days) compared to the Microsurgical group. One patient in the Endoscopic group had a complication (hemiparesis/pulmonary embolus). By contrast, 3 patients in the Microsurgical group had complications (seizure, ventriculitis/bone flap infection, and transient memory deficit). There was one recurrence in each group which both occurred at 5 years follow-up. The mean length of follow-up is 38 months in the Endoscopic group and 33 months in the Microsurgical group.

Conclusion:

Endoscopic resection of colloid cysts can be performed with significantly lower risk of complication than microsurgical resection and with equivalent surgical success. Operative time and length of hospital stay are both significantly reduced with endoscopic resection.

Résumé:

RÉSUMÉ:Objectif :

La résection endoscopique des kystes colloïs comme alternative à la résection microchirurgicale et à l'aspiration stéréotaxique est réalisée depuis 1982. Àce jour, peu d'études comparant ces interventions ont été publiées. Dans cette étude, nous présentons la plus grande série de résections endoscopiques publiée à ce jour et nous comparons les résultats à ceux d'une cohorte de patients ayant subi une résection microchirurgicale dans la même institution.

Méthodes :

Nous avons procédé à une révision des dossiers de tous les patients qui ont subi une résection d'un kyste colloï entre 1991 et 2004 dans la région sanitaire de Calgary. Nous avons comparé les patients traités par résection endoscopique à ceux traités par résection microchirurgicale.

Résultats :

Vingt-cinq interventions endoscopiques et neuf interventions microchirurgicales ont été pratiquées. La résection a été complète dans 24 des 25 interventions du groupe traité par endoscopie et dans les 9 interventions pratiquées par microchirurgie. Le temps opératoire était plus court chez les patients traités par endoscopie, soit une durée moyenne de 104 minutes versus 217 minutes pour le groupe traité par microchirurgie, et le séjour hospitalier était plus court, soit 3,8 jours par rapport à 8,4 jours, pour le groupe traité par microchirurgie. Un patient du groupe traité par endoscopie a subi une complication (hémiparésie/embolie pulmonaire). Trois patients du groupe traité par microchirurgie ont subi des complications (crise convulsive, ventriculite/infection du volet osseux et perte de mémoire transitoire). Il y a eu une récidive dans chaque groupe, toutes deux découvertes au cours du suivi, 5 ans après la chirurgie. La durée moyenne du suivi était de 38 mois pour le groupe traité par endoscopie et de 33 mois pour le groupe traité par microchirurgie.

Conclusion :

La résection endoscopique de kystes colloïs comporte significativement moins de risques de complications que la résection microchirurgicale et donne des résultats équivalents. Le temps opératoire et la durée d'hospitalisation sont significativement plus courts pour la résection endoscopique.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 2 , May 2007 , pp. 197 - 207
Copyright
Copyright © The Canadian Journal of Neurological 2007

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