Sayehmiri Fatemeh, Starke Robert M, Eichberg Daniel G, Ghanikolahloo Milad, Rahmatian Aryobarzan, Fathi Mobina, Vakili Kimia, Ebrahimzadeh Kaveh, Rezaei Omidvar, Samadian Mohammad, Mousavinejad Seyed Ali, Maloumeh Ehsan Nazari, Tavasol Hesameddin Hoseini, Sharifi Guive
Student research committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
Department of Neurosurgery, University of Miami, Miami, FL, United States.
Clin Neurol Neurosurg. 2022 Apr;215:107179. doi: 10.1016/j.clineuro.2022.107179. Epub 2022 Feb 18.
Colloid cysts are uncommon benign lesions. There is a lack of consensus regarding the preferred surgical strategy for colloid cyst resection; the technique with the optimal rates of remission, recurrence, mortality, and complications is debatable.
To determine surgical outcomes, we performed a systematic review of the published literature on Colloid cysts. Eligible studies (n = 63) with a prospective or retrospective evaluation of endoscopic or microscopic resection of third ventricle colloid cysts were included, which contained data describing extents of resection, seizures, meningitis, and tumor recurrence. A total of 3143 patients (1741 microscopically and 1402 endoscopically operated) were included in the final analysis.
According to the results of the meta-analysis, there was a higher rate of gross total resection (GTR) (98.15% versus 91.29%, p = 0.00), need for shunting (4.75% versus 1.46%, p = 0.04), postoperative complications (20.68% versus 10.42%, P = 0.03), mean operating time (194.18 versus 113.04 min), and duration of hospitalization (7.85 versus 4.69 days) for microscopic resection compared with endoscopic resection. While endoscopic resection is associated with a higher rate of cyst recurrence (1.78% versus 0.00%, P = 0.00), there was no difference in reoperation rate (0.49% for endoscopic versus 0.09% for microscopic resection).
Microsurgical resection of third ventricle colloid cysts was associated with a higher rate of GTR and a lower rate of recurrence, while there was a lower rate of postoperative complications, duration of surgery, and shorter hospitalization period in the endoscopic group.
胶样囊肿是罕见的良性病变。对于胶样囊肿切除的首选手术策略，目前尚无共识；关于缓解率、复发率、死亡率和并发症发生率最佳的技术仍存在争议。
为确定手术结果，我们对已发表的关于胶样囊肿的文献进行了系统评价。纳入了对第三脑室胶样囊肿进行内镜或显微镜下切除的前瞻性或回顾性评估的符合条件的研究（n = 63），这些研究包含描述切除范围、癫痫、脑膜炎和肿瘤复发的数据。最终分析纳入了总共3143例患者（1741例接受显微镜下手术，1402例接受内镜手术）。
根据荟萃分析结果，与内镜切除相比，显微镜下切除的全切除率（GTR）更高（98.15%对91.29%，p = 0.00），分流需求更高（4.75%对1.46%，p = 0.04），术后并发症更多（20.68%对10.42%，P = 0.03），平均手术时间更长（194.18对113.04分钟），住院时间更长（7.85对4.69天）。虽然内镜切除与囊肿复发率较高相关（1.78%对0.00%，P = 0.00），但再次手术率无差异（内镜手术为0.49%，显微镜下切除为0.09%）。
第三脑室胶样囊肿的显微手术切除与更高的全切除率和更低的复发率相关，而内镜组的术后并发症发生率、手术时间和住院时间更短。
