Endoscopic Excision of Colloid Cysts of the Third Ventricle: Six-Month Outcomes From a Single-Center Series of 22 Patients

Objective The objective of the study is to evaluate the safety, efficacy, and short-term outcomes of endoscopic excision of third-ventricular colloid cysts at a single tertiary care center in a resource-constrained environment. Methodology A retrospective review was conducted at the Punjab Institute of Neurosciences, Lahore, from January 2022 to May 2024. The study included 22 patients identified from institutional records including the Picture Archiving and Communication System (PACS) comprising consecutive eligible individuals who underwent endoscopic excision during the study period. Results The mean (standard deviation (SD)) age was 34.1 (15.0) years; 12 (54.5%) were female. Headache was the most common presenting symptom, followed by vomiting, drop attacks, and loss of consciousness. Complete excision was achieved in 19 (86.4%) patients. An external ventricular drain (EVD) was placed in 13 (59.1%) patients, and five (22.7%) required ventriculoperitoneal (VP) shunts (two preoperative and three postoperative). Postoperative complications included chemical meningitis in four (18.2%) patients and ventriculitis in two (9.1%) patients; overall, postoperative complications occurred in six (27.3%) patients. One death (4.5%) occurred. At six months, 20 patients completed follow-up; none reported recurrence of primary symptoms. Conclusion Endoscopic excision of third-ventricular colloid cysts was feasible in our series, with most patients achieving complete excision and favorable short-term outcomes. Complications and one mortality highlight the need for careful patient selection and standardized perioperative protocols. These results suggest that endoscopy can be a viable option in resource-limited settings, though longer follow-up and larger comparative studies are needed to confirm safety and long-term efficacy.