Controversy surrounds the fate of cyst remnants and recurrence rates following endoscopic colloid cyst resection. Previous studies have supported incomplete removal with cyst wall ablation.

     This study evaluates recurrence rates and clinical outcome in patients with total versus subtotal endoscopic resection of colloid cysts.

     Retrospective review was conducted of 65 consecutive patients and 67 procedures for endoscopic resection of colloid cysts from 1995 to 2010.

     Recurrence rates were compared between patients with complete resection and patients with cyst remnants. Data analysis was performed on 56 patients and 58 procedures, with no follow-up in 9 patients.

     There was no mortality. Morbidity included transient memory deficit (2), ventriculitis (1), conversion to craniotomy (1), and local wound infection. Secondary procedures included external ventricular drain placement (2) and ventriculoperitoneal shunting (2). Resection was subtotal in 9 cases and total in 45 cases (4 data unknown). Maximum follow up was 138 months (Mean = 34.0 mo). The overall recurrence rate was 6.89%, 33.3% (3/9) following subtotal resection and 2.2% (1/45) following total resection. (p= 0.0124) Mean follow up for patients with subtotal resection was 61.6 months, and for patients with total resection was 27.33 months.

     This is a retrospective study.

     Endoscopic colloid cyst resection results in a low overall recurrence rate. Ablation of cyst remnants rather than total removal is associated with a significantly higher rate of recurrence.

     Our results therefore support the intent of total removal when performing endoscopic resection of colloid cysts.