Gurses Muhammet Enes, Lu Victor M, Gecici Neslihan Nisa, Shah Khushi Hemendra, Gökalp Elif, Bashti Malek, Haider Sameah, Komotar Ricardo J
Department of Neurosurgery, Miami University, Miami, United States.
Hacettepe University School of Medicine, Ankara, Turkey.
Surg Neurol Int. 2024 May 31;15:179. doi: 10.25259/SNI_231_2024. eCollection 2024.
Colloid cysts are intracranial lesions originating from abnormalities in the primitive neuroepithelium folding of the third ventricle. Various surgical approaches have been explored for the management of colloid cysts, each carrying its own set of advantages and limitations. Tubular retractors developed recently alleviate retraction pressure through radial distribution, potentially offering benefits for colloid cyst resection. This study aims to introduce and assess a modified microsurgical method utilizing the tubular retractor for addressing colloid cysts.
The study included a retrospective assessment of patients who had colloid cysts and who were treated between 2015 and 2023 by one experienced surgeon. The demographic, clinical, radiological, histological, and surgical data regarding these patients were evaluated. The patients were assessed using the colloid cyst risk score, indicating a risk for obstructive hydrocephalus.
The minimally invasive microsurgical approach was successfully applied to all 22 identified patients. No postoperative surgical complications were reported. Gross total resection was achieved in 21 (95.5%) patients. The early complication rate was 22.7% ( = 5). There were no postoperative seizures, permanent neurological deficits, or venous injuries. The average hospital stay was 3 days. There was no evidence of recurrence at an average follow-up length of 25.9 months.
The transtubular approach is an effective, safe method for treating colloid cysts. It achieves complete cyst removal with minimal complications, offering the benefits of less invasiveness, improved visualization, and reduced tissue disruption, strengthening its role in colloid cyst surgery.
胶样囊肿是起源于第三脑室原始神经上皮折叠异常的颅内病变。针对胶样囊肿的治疗，人们探索了多种手术方法，每种方法都有其自身的优缺点。最近开发的管状牵开器通过径向分布减轻牵开压力，可能为胶样囊肿切除术带来益处。本研究旨在介绍和评估一种利用管状牵开器治疗胶样囊肿的改良显微手术方法。
该研究对2015年至2023年间由一位经验丰富的外科医生治疗的患有胶样囊肿的患者进行了回顾性评估。评估了这些患者的人口统计学、临床、放射学、组织学和手术数据。使用胶样囊肿风险评分对患者进行评估，该评分表明存在梗阻性脑积水的风险。
微创显微手术方法成功应用于所有22例确诊患者。未报告术后手术并发症。21例（95.5%）患者实现了全切除。早期并发症发生率为22.7%（n = 5）。无术后癫痫发作、永久性神经功能缺损或静脉损伤。平均住院时间为3天。平均随访25.9个月，无复发迹象。
经管状入路是治疗胶样囊肿的一种有效、安全的方法。它能以最小的并发症实现囊肿完全切除，具有侵入性小、视野改善和组织破坏减少的优点，强化了其在胶样囊肿手术中的作用。
