Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Oper Neurosurg (Hagerstown). 2019 May 1;16(5):571-579. doi: 10.1093/ons/opy249.
Colloid cysts are challenging lesions to access. Various surgical approaches are utilized which all require brain retraction, creating focal pressure, local trauma, and potentially surgical morbidity. Recently, tubular retractors have been developed that reduce retraction pressure by distributing it radially. Such retractors may be beneficial in colloid cyst resection.
To retrospectively review a single neurosurgeon's case series, as well as the literature, to determine the efficacy and safety profile of transtubular colloid cyst resections. We also aim to describe our operative technique for this approach.
We conducted a retrospective review of colloid cyst resections using either ViewSite Brain Access System (Vycor Medical, Boca Raton, Florida) or BrainPath (NICO, Indianapolis, Indiana) tubular retractors performed by a single neurosurgeon from 2015 to 2017 (n = 10). A literature review was performed to find all published cases of transtubular colloid cyst resections.
Gross total resection was achieved in all patients. Early neurologic deficit rate was 10% (n = 1), and permanent neurologic deficit rate was 0%. There were no postoperative seizures or venous injuries. Average hospital stay was 2.0 d. There was no evidence of recurrence at average follow-up length of 13.6 mo. A literature review demonstrated nine studies (n = 77) with an overall complication rate of 7.8%.
Tubular retractors offer an attractive surgical corridor for colloid cyst resections, avoiding much of the morbidity of interhemispheric approaches, while minimizing damage to normal cortex. There were no permanent complications in our series of ten cases, and a literature review found a similarly benign safety profile.
胶样囊肿是难以触及的病变。各种手术方法都需要脑牵开，造成局部压力、局部创伤，并可能导致手术发病率。最近，开发了管状牵开器，通过向径向分布来减少牵开压力。这种牵开器在胶样囊肿切除中可能是有益的。
回顾性分析单一神经外科医生的病例系列，以及文献，以确定经管状胶样囊肿切除术的疗效和安全性。我们还旨在描述我们这种方法的手术技术。
我们对 2015 年至 2017 年间由单一神经外科医生使用 ViewSite Brain Access System（Vycor Medical，佛罗里达州博卡拉顿）或 BrainPath（NICO，印第安纳波利斯）管状牵开器进行的胶样囊肿切除术进行了回顾性研究（n=10）。进行了文献复习，以找到所有经管状胶样囊肿切除术的已发表病例。
所有患者均实现了大体全切除。早期神经功能缺损率为 10%（n=1），永久性神经功能缺损率为 0%。无术后癫痫发作或静脉损伤。平均住院时间为 2.0 天。平均随访 13.6 个月后，无复发证据。文献复习显示，有 9 项研究（n=77）的总并发症发生率为 7.8%。
管状牵开器为胶样囊肿切除术提供了一个有吸引力的手术通道，避免了大多数半球间入路的发病率，同时最大限度地减少了对正常皮质的损伤。在我们的 10 例病例系列中，没有永久性并发症，文献复习发现类似的良性安全性特征。
