Endoscopic Surgery of Third Ventricular Lesions

Abstract
Background: The endoscopic surgery to third ventricular lesions are now widely used as it is less invasive than the traditional microsurgical procedures.
Aim of Study: To evaluate endoscopic surgery of third ventricular lesions as regards clinical improvement, compli-cation rate and extent of lesion resection.
Patients and Methods: Retrospectively eleven cases of third ventricular lesions (seven cases of colloid cyst, two cases of astrocytoma, one case epidermoid cyst and 1 case of arachnoid cyst) were operated upon through endoscopic route for total excision if feasible, pre-operative assessment in the form of full neurological examination and imaging (CT and MRI) were done for all patients. Incompletely removed lesions were managed by a septostomy and VP shunt, post-operatively CT was performed in the first 24 hours after surgery and another after 48 hours, MRI with contrast was done 6 months post-operatively to detect recurrence, patients with persistent post-operative hydrocephalus had VP shunt insertion.
Results: Complete resection was achieved in nine patients (82%), while resection was incomplete in two cases (18%). complications were in one case (9%) in the form of short memory affection improved after one month, post-operative hydrocephalus was in one patient (9%), mean length of hospital stay was three and half days, no recurrence was reported in all patients with complete resection for a follow-up period of 12 months.
Conclusion: Endoscopic resection of third ventricular lesions is safe, minimally invasive, technically feasible and with good outcome especially in completely removed lesions.