Comparative analysis of endoscopic and microsurgical approaches for third ventricle colloid cyst tr: A retrospective study

Objective: Colloid cyst surgery remains a debated topic and is commonly performed using microsurgery and endoscopic methods nowadays. Both approaches have their specific advantages and disadvantages. This study aims to contribute to the literature by comparing the results of both methods applied in our practice. Materials and Methods: The study consists of a total of 40 patients diagnosed with colloid cyst, who underwent surgery using 21 endoscopic and 19 open microsurgical methods. The medical records, surgery notes, radiological images, and outpatient follow-up notes of all operated patients were retrospectively reviewed, and the obtained data were analyzed using the SPSS program. Results: Patients who underwent endoscopic surgery had shorter postoperative hospital stays compared to the open microsurgery group (p<0.001), while open microsurgery was found to be more effective in terms of gross total resection (p=0.004; p<0.05). The recurrence rate in patients treated with the endoscopic method was 9.5%, whereas it was zero in the microsurgery group; however, this difference was not statistically significant (p=0.488; p<0.05). There was no significant difference in morbidity, mortality, and reoperation rates. Each unit increase in cyst diameter was found to increase the complication risk by approximately 1.1 times in patients treated with microsurgery (p=0.052; p<0.05). There was no significant relationship between permanent shunt application and surgical methods. Conclusion: There is no definitive superiority among the preferred methods for the surgical treatment of colloid cysts. The results of our study are consistent with the general literature on this matter. Surgical decisions can vary depending on many factors; therefore, each patient's unique situation should be thoroughly evaluated, and an appropriate treatment plan should be established. In this context, further research is needed, and we believe that all neurosurgeons should be proficient in both methods, both technically and theoretically. Keywords: endoscopic cyst excision, colloid cyst, colloid cyst risk score, microscopic cyst excision, third ventricle tumors