Increasing the Implication of Endoscopy to a Wide Spectrum of Intraventricular Lesions: A Review of Our Experience

Amir Aziz, Khurram Ishaque


Introduction: Though traditional microsurgical techniques are the gold standard for intraventricular tumor resection, the morbidity and invasiveness of microsurgical approaches to the ventricular system have galvanized interest in neuroendoscopic resection. We present a case series to share our experience with endoscopic management of intraventricular lesion.
Materials and Methods: 17 patients, both male and female, from 5 to 50 years of age were endoscopically operated during 1.5 years. Intraventricular lesions < 4cm, mildly vascular and soft in consistency were included. The average operative time was 90 minutes and the average hospital stay was 4 ± 1.5 days. Follow up was done at 2 weeks, 6weeks and at 6 months.
Results: Out of 12 males and 5 females there were 6 colloid cysts, 3 supra sellar arachnoid cysts, 5 intraventri-cular tumors and 3 pineal tumors. Complete resection of lesion was achieved in 4 out of 6 patients with colloid cyst (66.6%). Size of supra sellar arachnoid cyst reduced along with improvement of hydrocephalus in all 3 patients (100%) Positive tumor biopsy was possible in 100% of cases. Adjuvant endoscopic third ventriculostomy was performed in 9 (52.9%). Septostomy was done in 1 (5.9%). Post op Ventriculoperitoneal shunt was required in 4 (23.5%) cases. There was no peri or post operative mortality.
Conclusion: With proper patient selection endoscopic surgery can yield results at par with microsurgery with added benefits of minimum patient discomfort, shorter hospital stay and improved cosmetic results.
Key word: Intraventricular tumor, colloid cyst, arachnoid cyst, pineal tumor, ventriculostomy, septostomy.

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