Endoscopic Colloid Cyst Resection: A Case Series and Systematic Review.

[BACKGROUND AND OBJECTIVES] Endoscopic surgery offers a minimally invasive alternative to microsurgical resection for intraventricular lesions such as colloid cysts, with potential advantages in morbidity and recovery. Although microsurgery remains a common procedure, endoscopic techniques are increasingly used, despite limited long-term outcomes data. This study presents a single institution case series assessing clinical outcomes after endoscopic resection with a comparison with open and endoscopic series through systematic review.

[METHODS] A retrospective analysis from 2014 to 2025 was conducted, evaluating consecutive patients who underwent endoscopic colloid cyst resection at a single institution by a single surgeon. Demographics, preoperative hydrocephalus, perioperative complications, recurrence, and need for reoperation were followed. Outcomes were compared with published literature on open and endoscopic approaches.

[RESULTS] Sixty-three patients were initially identified. Four were excluded as pathology was not colloid cyst. This resulted in a total of 59 patients for analysis. Average age at the time of diagnosis was 47 years with an average cyst size of 12.9 mm; 86.4% of patients had preoperative hydrocephalus. Patients were followed for an average of 32.5 months. Only one patient needed reoperation; this was for obstructive hydrocephalus, which was cured by using septostomy. There were no reoperations for colloid cyst recurrence; 96.6% of patients achieved gross total resection (GTR; 100% by radiographic analysis). There were no patients who were shunt dependent, no infections, and no mortality.

[CONCLUSION] Endoscopic resection of colloid cysts at our center has a high rate of GTR that is significantly better than other open and endoscopic series (including a lower recurrence rate and morbidity). Systematic review shows that endoscopic resection has a statistically significantly improved overall morbidity, including rates of infection and seizure, although it has an overall lower rate of GTR than open surgery. Our results support the efficacy and safety of the endoscopic approach for resection of colloid cysts.