title: Transcortical Removal of Third Ventricular Colloid Cysts: Comparison of Conventional, Guided Microsurgical and Endoscopic Approaches and Review of the Literature.
abstract: OBJECTIVE
  To compare the clinical results of different transcortical approaches for the removal of third ventricular colloid cysts (CC).
  
  
  METHODS
  Records of 41 colloid cyst patients who underwent transcortical conventional microsurgical, microsurgical with the aid of stereotactically guided cylindrical retractor (minitubular), and endoscopic removal between 1999 and 2015 were retrospectively analyzed. The clinical results of these three different transcortical surgical approaches were compared and a literature review of published series was conducted.
  
  
  RESULTS
  Ages ranged between 16 and 66 years (mean: 36.8). There were 18 female and 23 male patients. Headache was the main presenting symptom. The mean CC diameter was 15.5 mm. Intraventricular hemorrhage was encountered in 2 patients. Three patients needed postoperative ventriculoperitoneal shunt surgery. Postoperative seizures were seen in 3, postoperative neurological deficit in 3 and residual tumor in 2 patients. The conventional approach resulted in significantly higher rates of postoperative seizure compared to the minitubular and endoscopic approaches (p=0.012). The rate of residual cyst was significantly higher in endoscopic approach compared to conventional and minitubular approaches (p=0.024). Conventional approach led to significantly higher rates of neurological deficit compared to the two other approaches (p < 0.05).
  
  
  CONCLUSIONS
  With respect to complication rates, the stereotactic and endoscopic approaches are both safe and reliable compared to conventional microsurgical approach that has unacceptably high rates of seizures and neurological deficit. Concerning completeness of removal, both microsurgical approaches are by far superior to neuroendoscopy. The stereotactic microsurgical approach compares favorably in both respects with endoscopic and conventional microsurgical approaches.
authors.affiliation: Istanbul University, Istanbul School of Medicine, Department of Neurosurgery, Istanbul, Turkey.
authors.forename: Pulat Akin
authors.initials: PA
authors.lastname: Sabanci
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Aras
authors.forename: Achmet
authors.initials: A
authors.lastname: Ali
authors.forename: Tugrul Cem
authors.initials: TC
authors.lastname: Unal
authors.forename: Duygu
authors.initials: D
authors.lastname: Dolen
authors.forename: Serra
authors.initials: S
authors.lastname: Sencer
authors.forename: Nail
authors.initials: N
authors.lastname: Izgi
authors.forename: Faruk
authors.initials: F
authors.lastname: Unal
authors.forename: Orhan
authors.initials: O
authors.lastname: Barlas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000601:surgery; D056364:Colloid Cysts / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008866:Microsurgery / Q000009:adverse effects*; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult