title: Twenty colloid cysts--comparison of endoscopic and microsurgical management.
abstract: The management of colloid cyst remains controversial, evaluation of the competing methods seems to be necessary. We report on our experience with colloid cysts in the last decade: ten were managed solely endoscopically, 10 were resected microsurgically (9 via a transcortical/transventricular, 1 via a transcallosal approach). The outcome in the endoscopic group was excellent in 9 cases and unsatisfying in 1 case (recurrence). In the microsurgical group we achieved a good outcome in 5 of 10 cases, a fair outcome in 4 cases and 1 lethal outcome (caused by pulmonary embolism). Complications in the endoscopic group: one intraoperative bleeding, 1 stitch granuloma, 1 mispuncture of the ventricle, and 1 meningitis. Complications in the microsurgical group: 1 subdural effusion, 1 flap infection, 1 mild hemiparesis, 1 transient impairment of consciousness and 1 pulmonary embolism. Mean operative time and length of hospitalization of the endoscopic group were clearly shorter than in the microsurgical group: 91 min versus 267 min time of surgery, 5.1 days versus 18.9 days of hospitalization. Complete resection was achieved in 8 of 10 cases of microsurgery, and in 3 of 10 cases in endoscopy. Endoscopic management results in lower costs and superior patients' comfort. The reduced number of total resections in the endoscopic group may lead to a higher recurrence rate in long-term follow-up, which might be a serious disadvantage of endoscopy. However, more experience in the endoscopic techniques may result in a higher rate of total resection of colloid cysts.
authors.affiliation: Department of Neurosurgery, Medical University of Lübeck, Lübeck, Germany. kehler@uke.uni-hamburg.de
authors.forename: U
authors.initials: U
authors.lastname: Kehler
authors.forename: A
authors.initials: A
authors.lastname: Brunori
authors.forename: J
authors.initials: J
authors.lastname: Gliemroth
authors.forename: G
authors.initials: G
authors.lastname: Nowak
authors.forename: A
authors.initials: A
authors.lastname: Delitala
authors.forename: F
authors.initials: F
authors.lastname: Chiappetta
authors.forename: H
authors.initials: H
authors.lastname: Arnold
mesh_terms: D000328:Adult; D000368:Aged; D020863:Central Nervous System Cysts / Q000175:diagnosis / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome