Artikel
Colloid cysts of the third ventricle: endoscopic or microsurgical approach: our experience
Suche in Medline nach
Autoren
Veröffentlicht: | 4. Mai 2005 |
---|
Gliederung
Text
Objective
Colloid cysts of the third ventricle account for 0.3-2% of all intracranial tumors. The treatment of these benign neuroepithelial tumors remains controversial : and the best surgical option has not been established. We report our experience on the microsurgical and endoscopic treatment of these lesions in children and adults.
Methods
31 (5 children) patients have been treated between 1974 to 2004. 18 patients were treated with a microsurgical approach (group A). 13 patients were treated with endoscopic approach associated in same cases with a third ventriculocysternostomy (group B). In the group A, in 12 patients we have made a transcortical approach and in 4 a transcallosal approach; 2 patients had only a shunt. In this group a total removal of the lesion was possible in all patients. The clinical outcome was good in 8 (recovery of job and daily activities) and poor (loss of the job) in 4 patients.4 patients dead with a mortality of 22%. The group B of 13 patients (5 children) was treated endoscopically. After a postoperative MRI study, a total removal was performed in only 1 patient while in the others patients the removal was at least 70% of the initial volume.
Results
The clinical outcome was good in 10 patients: 6 adultes could work normally and 4 children had a normal scolarity. In 3 patients the results were judged poor because 2 patients were not able to work normally for behaviour problems and 1 children was unable to follow a normal scolarity course. There was not a surgical or postoperative mortality in this group.
Conclusions
The microsurgical approach allowed a total removal of the tumor, with an high mortality (22%). With the endoscopic technique we reported a low morbidity and any surgical mortality. With endoscopic approach a total removal of the tumor wall seems us difficult and sometimes dangereus also in experienced hands. We consider the neuroendoscopy as a safe and efficient surgical technique for the treatment of cyst colloid of the third ventricle but total removal of the lesions is in our experience only rarely was obatined.