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Surgical approaches for resection of third ventricle colloid cysts: meta-analysis

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Abstract

Although outcome studies and systematic reviews have been published on the surgical treatment of third ventricle colloid cysts (TVCC), there are no meta-analyses that compare the outcomes for various surgical approaches. This meta-analysis assesses the outcomes and complications for transcortical, transcallosal, and endoscopic surgical approaches used to excise TVCCs. A meta-analysis of surgically excised TVCCs was performed with an assessment of outcome for transcortical, transcallosal, and endoscopic approaches. A random-effects model analyzed the extent of surgical excision. The analysis included reports that compared at least two of these surgical approaches, for a total of 11 studies comprising a population of 301 patients. The transcortical approach was associated with a higher incidence of complete excision compared to the endoscopic approach (OR = 0.137, p = 0.041), with no significant differences observed between transcortical and transcallosal approaches, and between transcallosal and endoscopic approaches. Comparison between endoscopic and pooled microsurgical approaches was also insignificant (OR = 0.22, p = 1). The risk of motor weakness was increased with the transcortical approach compared to the endoscopic approach (OR = 6.10, p = 0.018). There were no significant differences between transcortical and transcallosal approaches regarding newly onset seizures, and no significant mortality differences between all three approaches. This study demonstrates that microsurgical approaches are associated with a greater extent of resection compared to endoscopic approaches; however, best results are likely achieved based on the surgeon’s expertise, flexibility, and case review.

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References

  1. Alnaghmoosh N, Alkhani A (2006) Colloid cysts in children, a clinical and radiological study. Childs Nerv Syst 22:514–516. https://doi.org/10.1007/s00381-005-0017-z

    Article  PubMed  Google Scholar 

  2. Bavil MS, Vahedi P (2007) Familial colloid cyst of the third ventricle in non-twin sisters: case report, review of the literature, controversies, and screening strategies. Clin Neurol Neurosurg 109:597–601. https://doi.org/10.1016/j.clineuro.2007.04.017

    Article  PubMed  Google Scholar 

  3. Beaumont TL, Limbrick DD Jr, Rich KM, Wippold FJ 2nd, Dacey RG Jr (2016) Natural history of colloid cysts of the third ventricle. J Neurosurg 125:1420–1430. https://doi.org/10.3171/2015.11.JNS151396

    Article  PubMed  Google Scholar 

  4. Connolly ID, Johnson E, Lamsam L, Veeravagu A, Ratliff J, Li G (2017) Microsurgical vs. endoscopic excision of colloid cysts: an analysis of complications and costs using a longitudinal administrative database. Front Neurol 8:259. https://doi.org/10.3389/fneur.2017.00259

    Article  PubMed  PubMed Central  Google Scholar 

  5. de Witt Hamer PC, Verstegen MJ, De Haan RJ, Vandertop WP, Thomeer RT, Mooij JJ, van Furth WR (2002) High risk of acute deterioration in patients harboring symptomatic colloid cysts of the third ventricle. J Neurosurg 96:1041–1045

    Article  Google Scholar 

  6. Desai KI, Nadkarni TD, Muzumdar DP, Goel AH (2002) Surgical management of colloid cyst of the third ventricle—a study of 105 cases. Surg Neurol 57:295–302

    Article  Google Scholar 

  7. Ehni G (1984) Interhemispheric and percallosal (transcallosal) approach to the cingulate gyri, intraventricular shunt tubes, and certain deeply placed brain lesions. Neurosurgery 14:99–110

    Article  CAS  Google Scholar 

  8. Eichberg DG, Sedighim S, Buttrick S, Komotar RJ (2018) Postoperative seizure rate after transcortical resection of subcortical brain tumors and colloid cysts: a single surgeon’s experience. Cureus 10:e2115. https://doi.org/10.7759/cureus.2115

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ellenbogen RG (2001) Transcortical surgery for lateral ventricular tumors. Neurosurg Focus 10:1–13

    Article  Google Scholar 

  10. Greenlee JDW, Teo C, Ghahreman A, Kwok B (2008) Purely endoscopic resection of colloid cysts. Oper Neurosurg 62:ONS51–ONS56. https://doi.org/10.1227/01.neu.0000317373.00018.6f

    Article  Google Scholar 

  11. Grondin RT, Hader W, MacRae ME, Hamilton MG (2007) Endoscopic versus microsurgical resection of third ventricle colloid cysts. Can J Neurol Sci 34:197–207. https://doi.org/10.1017/s0317167100006041

    Article  PubMed  Google Scholar 

  12. Heller RS, Heilman CB (2020) Colloid cysts: evolution of surgical approach preference and management of recurrent cysts. Oper Neuro 18(1):19-25. https://doi.org/10.1093/ons/opz059

  13. Hellwig D, Bauer BL, Schulte M, Gatscher S, Riegel T, Bertalanffy H (2003) Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade. Neurosurgery 52:525–533; discussion 532-523. https://doi.org/10.1227/01.neu.0000047671.27057.55

    Article  PubMed  Google Scholar 

  14. Hernesniemi J, Romani R, Dashti R, Albayrak BS, Savolainen S, Ramsey C 3rd, Karatas A, Lehto H, Navratil O, Niemela M (2008) Microsurgical treatment of third ventricular colloid cysts by interhemispheric far lateral transcallosal approach--experience of 134 patients. Surg Neurol 69:447–453; discussion 453-446. https://doi.org/10.1016/j.surneu.2007.11.005

    Article  PubMed  Google Scholar 

  15. Hoffman CE, Savage NJ, Souweidane MM (2013) The significance of cyst remnants after endoscopic colloid cyst resection: a retrospective clinical case series. Neurosurgery 73:233–237; discussion 237-239. https://doi.org/10.1227/01.neu.0000430300.10338.71

    Article  PubMed  Google Scholar 

  16. Horn EM, Feiz-Erfan I, Bristol RE, Lekovic GP, Goslar PW, Smith KA, Nakaji P, Spetzler RF (2007) Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection. Neurosurgery 60:613–618; discussion 618-620. https://doi.org/10.1227/01.NEU.0000255409.61398.EA

    Article  PubMed  Google Scholar 

  17. Jeffree RL, Besser M (2001) Colloid cyst of the third ventricle: a clinical review of 39 cases. J Clin Neurosci 8:328–331. https://doi.org/10.1054/jocn.2000.0800

    Article  PubMed  CAS  Google Scholar 

  18. Kehler U, Brunori A, Gliemroth J, Nowak G, Delitala A, Chiappetta F, Arnold H (2001) Twenty colloid cysts-comparison of endoscopic and microsurgical management. min-Minimally Invasive. Neurosurgery 44:121–127

    CAS  Google Scholar 

  19. King WA, Ullman JS, Frazee JG, Post KD, Bergsneider M (1999) Endoscopic resection of colloid cysts: surgical considerations using the rigid endoscope. Neurosurgery 44:1103–1109

    Article  CAS  Google Scholar 

  20. Konovalov AN, Pitskhelauri DI, Shkarubo M, Buklina SB, Poddubskaya AA, Kolycheva M (2017) Microsurgical treatment of colloid cysts of the third ventricle. World Neurosurg 105:678–688. https://doi.org/10.1016/j.wneu.2017.06.012

    Article  PubMed  Google Scholar 

  21. Lagman C, Rai K, Chung LK, Nagasawa DT, Beckett JS, Tucker AM, Yang I (2017) Fatal colloid cysts: a systematic review. World Neurosurg 107:409–415. https://doi.org/10.1016/j.wneu.2017.07.183

    Article  PubMed  Google Scholar 

  22. Levine N, Miller M, Crone K (2007) Endoscopic resection of colloid cysts: indications, technique, and results during a 13-year period. min-Minimally Invasive. Neurosurgery 50:313–317

    CAS  Google Scholar 

  23. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151:W-65–W-94

    Article  Google Scholar 

  24. Little JR, MacCarty CS (1974) Colloid cysts of the third ventricle. J Neurosurg 40:230–235

    Article  CAS  Google Scholar 

  25. Longatti P, Godano U, Gangemi M, Delitala A, Morace E, Genitori L, Alafaci C, Benvenuti L, Brunori A, Cereda C, Cipri S, Fiorindi A, Giordano F, Mascari C, Oppido PA, Perin A, Tripodi M, Italian neuroendoscopy g (2006) Cooperative study by the Italian neuroendoscopy group on the treatment of 61 colloid cysts. Childs Nerv Syst 22:1263–1267. https://doi.org/10.1007/s00381-006-0105-8

    Article  PubMed  CAS  Google Scholar 

  26. Maqsood AA, Devi IB, Mohanty A, Chandramouli B, Sastry KV (2006) Third ventricular colloid cysts in children. Pediatr Neurosurg 42:147–150

    Article  Google Scholar 

  27. Mathiesen T, Grane P, Lindgren L, Lindquist C (1997) Third ventricle colloid cysts: a consecutive 12-year series. J Neurosurg 86:5–12

    Article  CAS  Google Scholar 

  28. Milligan BD, Meyer FB (2010) Morbidity of transcallosal and transcortical approaches to lesions in and around the lateral and third ventricles: a single-institution experience. Neurosurgery 67:1483–1496; discussion 1496. https://doi.org/10.1227/NEU.0b013e3181f7eb68

    Article  PubMed  Google Scholar 

  29. Nachev P, Wydell H, O’Neill K, Husain M, Kennard C (2007) The role of the pre-supplementary motor area in the control of action. Neuroimage 36(Suppl 2):T155–T163. https://doi.org/10.1016/j.neuroimage.2007.03.034

    Article  PubMed  Google Scholar 

  30. Sabanci PA, Aras Y, Ali A, Unal TC, Dolen D, Sencer S, Izgi N, Unal F, Barlas O (2017) Transcortical removal of third ventricular colloid cysts: comparison of conventional, guided microsurgical and endoscopic approaches and review of the literature. Turk Neurosurg 27:546–557. https://doi.org/10.5137/1019-5149.JTN.17142-16.2

    Article  PubMed  Google Scholar 

  31. Sampath R, Vannemreddy P, Nanda A (2010) Microsurgical excision of colloid cyst with favorable cognitive outcomes and short operative time and hospital stay: operative techniques and analyses of outcomes with review of previous studies. Neurosurgery 66:368–374; discussion 374-365. https://doi.org/10.1227/01.NEU.0000363858.17782.82

    Article  PubMed  Google Scholar 

  32. Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007) Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak 7:16

    Article  Google Scholar 

  33. Schroeder HW, Gaab MR (2002) Endoscopic resection of colloid cysts. Neurosurgery 51:1441–1445

    Article  Google Scholar 

  34. Sethi A, Cavalcante D, Ormond DR (2019) Endoscopic versus microscopic transcallosal excision of colloid cysts: a systematic review in the era of complete endoscopic excision. World Neurosurg 132:e53–e58

    Article  Google Scholar 

  35. Shapiro S, Rodgers R, Shah M, Fulkerson D, Campbell RL (2009) Interhemispheric transcallosal subchoroidal fornix-sparing craniotomy for total resection of colloid cysts of the third ventricle. J Neurosurg 110:112–115. https://doi.org/10.3171/2008.4.17495

    Article  PubMed  Google Scholar 

  36. Sheikh AB, Mendelson ZS, Liu JK (2014) Endoscopic versus microsurgical resection of colloid cysts: a systematic review and meta-analysis of 1278 patients. World Neurosurg 82:1187–1197

    Article  Google Scholar 

  37. Shucart WA, Stein BM (1978) Transcallosal approach to the anterior ventricular system. Neurosurgery 3:339–343

    PubMed  CAS  Google Scholar 

  38. Stachura K, Libionka W, Moskała M, Krupa M, Polak J (2009) Colloid cysts of the third ventricle. Endoscopic and open microsurgical management. Neurol Neurochir Pol 43:251–257

    PubMed  Google Scholar 

  39. Staub BN, Rangel-Castilla L, Olar A, Baskin DS (2014) Olfactory colloid cyst: case report and review of extraventricular colloid cyst literature. World Neurosurg 81(202):e219–e222. https://doi.org/10.1016/j.wneu.2013.07.080

    Article  Google Scholar 

  40. Symss NP, Ramamurthi R, Rao SM, Vasudevan MC, Jain PK, Pande A (2011) Management outcome of the transcallosal, transforaminal approach to colloid cysts of the anterior third ventricle: an analysis of 78 cases. Neurol India 59:542–547. https://doi.org/10.4103/0028-3886.84334

    Article  PubMed  Google Scholar 

  41. Türe U, Yaşargil MG, Krisht AF (1996) The arteries of the corpus callosum: a microsurgical anatomic study. Neurosurgery 39:1075–1084. https://doi.org/10.1097/00006123-199612000-00001

    Article  PubMed  Google Scholar 

  42. Vazhayil V, Sadashiva N, Nayak N, Prabhuraj AR, Shukla D, Somanna S (2018) Surgical management of colloid cysts in children: experience at a tertiary care center. Childs Nerv Syst 34:1215–1220. https://doi.org/10.1007/s00381-018-3760-7

    Article  PubMed  Google Scholar 

  43. Weaver KJ, McCord M, Neal D, Bova F, Rajon D, Quinones-Hinojosa A, Rahman M (2016) Do tumor and ventricular volume predict the need for postresection shunting in colloid cyst patients? J Neurosurg 125:585–590. https://doi.org/10.3171/2015.9.JNS151183

    Article  PubMed  Google Scholar 

  44. Wilson DA, Fusco DJ, Wait SD, Nakaji P (2013) Endoscopic resection of colloid cysts: use of a dual-instrument technique and an anterolateral approach. World Neurosurg 80:576–583. https://doi.org/10.1016/j.wneu.2012.07.014

    Article  PubMed  Google Scholar 

  45. Woiciechowsky C, Vogel S, Lehmann R, Staudt J (1995) Transcallosal removal of lesions affecting the third ventricle: an anatomic and clinical study anatomical report. Neurosurgery 36:117–123. https://doi.org/10.1227/00006123-199501000-00015

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We appreciate the statistical assistance of Michael Lasarev, who provided example coding so we could perform the meta-analysis.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, CSC K8/828, 600 Highland Avenue, Madison, WI, 53792, USA

    Walid Elshamy, Ufuk Erginoglu, Abdurahman Aycan, Burak Ozaydin, Robert J. Dempsey & Mustafa K. Baskaya

  2. Department of Neurological Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Walid Elshamy & Mina Gerges

  3. University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA

    Jake Burkard

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Walid Elshamy, Robert J. Dempsey, and Mustafa K. Baskaya. The first draft of the manuscript was written by Walid Elshamy, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mustafa K. Baskaya.

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Elshamy, W., Burkard, J., Gerges, M. et al. Surgical approaches for resection of third ventricle colloid cysts: meta-analysis. Neurosurg Rev 44, 3029–3038 (2021). https://doi.org/10.1007/s10143-021-01486-5

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