SURGICAL RESECTION OF 3RD VENTRICLE COLLOID CYSTS - PRELIMINARY-RESULTS COMPARING TRANSCALLOSAL MICROSURGERY WITH ENDOSCOPY

It is still not determined which is the best surgical option for third ventricle colloid cysts. Since 1990, the authors have used a steerabl e fiberscope to remove colloid cysts in seven patients and have perfor med microsurgery via a transcallosal approach in eight patients. The t wo techniques were compared for operating time, length of hospital sta y, incidence of complications, recurrence, and hydrocephalus, and days spent recuperating before return to work to determine if endoscopic r emoval of colloid cysts is a safe and effective alternative to microsu rgery. Statistical analysis was adjusted for age, sex, and presenting symptoms. Microsurgical cases averaged 206 minutes of operating time w hereas endoscopic cases averaged 127 minutes (p = 0.01). For combined days spent in the intensive care unit and on the ward, the patients av eraged 9.5 days after microsurgery and 4 days after endoscopy (p = 0.0 5). Postoperative complications occurred in five of eight patients aft er microsurgery and in one of seven patients after endoscopy (p = 0.09 ); complications were transient and primarily related to short-term me mory loss. In all patients, preoperative symptoms resolved and the cys ts have not recurred. Postoperatively, one patient required a ventricu loperitoneal shunt after microsurgery but all patients were shunt-inde pendent after endoscopy. Patients returned to work an average of 59 da ys after discharge following microsurgery compared with an average of 26 days after endoscopy (p = 0.05). Compared with transcallosal micros urgery for the removal of colloid cysts, these preliminary results sho w that a steerable endoscope reduced operating time and that patients spent fewer days in the hospital and returned to work sooner after end oscopy.