Long-Term Results After Endoscopic Resection of Colloid Cysts

Endoscopic resection of colloid cysts is a widely accepted treatment option instead of microsurgery. However, there is still a debate about a potentially higher rate of incomplete resections and recurrence. The aim of this retrospective study was to evaluate long-term results after endoscopic removal of colloid cysts. Twenty patients underwent endoscopic treatment in our department. Eighteen patients agreed to follow-up examinations. In 17 patients, magnetic resonance images were obtained. Total cyst resection was achieved in 16 procedures. In 1 patient, only plexus coagulation and widening of the ipsilateral foramen of Monro were performed. In 3 patients, small remnants of the cyst membrane were left behind. Conversion to microsurgery became necessary in 1 patient. Mild temporary complications occurred in 6 patients. Preoperative symptoms were completely relieved in 16 patients and improved in 2 patients. The average follow-up period was 188 months. In the patient with plexus coagulation, the cyst did not change. Recurrence occurred in 2 of 3 patients with cyst remnants. To date, no cyst remnant or recurrence has caused any symptoms or required surgical treatment. Our results indicate that endoscopic treatment of colloid cysts is a safe and effective treatment option that provides excellent long-term results. However, we determined that a significant risk for recurrence exists when even small parts of the cyst capsule were left behind. Therefore, we advocate an attempt at total endoscopic cyst resection. •In our study we achieved excellent outcome results after endoscopic colloid cyst resection.•The long follow-up period of >10 years on average is exceptional in the literature.•Low complication rate and high rate of total resection showed that endoscopic treatment is safe and effective.•We showed that there is a significant risk of cyst recurrence even when small remnants were left behind.•We advocate an attempt of total endoscopic cyst resection as the first line treatment.