A Retrospective Cohort Study of Neuroendoscopic Surgery versus Traditional Craniotomy on Surgical Success Rate, Postoperative Complications, and Prognosis in Patients with Acute Intracerebral Hemorrhage

Abstract

Objective. A case-control study was adopted to explore the effect of neuroendoscopy compared with traditional craniotomy on the success rate, postoperative complications, and prognosis of patients with intracerebral hemorrhage (ICH). Methods. The clinical data of 106 patients with ICH treated in our hospital from March 2019 to June 2021 were collected and analyzed retrospectively and divided into two groups according to different treatment methods. The patients who were cured by craniotomy were in the control group (n = 53), and those who received neuroendoscopic surgery were in the research group (n = 53).The clinical efficacy of patients was compared, and the cognition and daily living ability were evaluated by the Trier cognitive assessment scale, limb motor function score, and activity of daily living scale. The National Institutes of Health Stroke scale (NIHSS) and Glasgow coma scale (GCS) were used to compare the neurological function of the two groups before and after treatment, and the Glasgow outcome scale (GOS) and disability rating scale (DRS) were adopted to evaluate the functional prognosis. The simplified Fugl-Meyer motor function score was adopted to evaluate the patient’s limb function, the Montreal cognitive assessment scale was adopted to evaluate the patient’s cognitive function, the Barthel index score was adopted to evaluate the daily living ability of patients, and the treatment of patients was recorded. Results. In comparison with groups, the effective rate of treatment in the research group was higher, and the difference between groups was statistically significant ( P < 0.05 ). Regarding the surgical indicators, the hospital stay, intraoperative blood loss, postoperative residual blood flow, and total hospital stay in the research group were remarkably lower, the hematoma clearance rate in the research group was remarkably higher, and the difference between groups was statistically significant( P < 0.05 ). After operation, the KPS scores indicated a gradual upward trend, and those of the research group were higher at 1 month, 2 months, and 3 months after operation. The Barthel index scores were compared. After treatment, the Barthel index scores increased. In comparison with the two groups, the Barthel index scores of the research group were higher at 1 month, 2 months, and 3 months after surgery, and the difference between groups was statistically significant ( P < 0.05 ). The NIHSS, GCS, and DRS scores were compared. After treatment, the NIHSS, GCS, and DRS scores were decreased. In comparison with the two groups, the NIHSS, GCS, and DRS scores of the research group were remarkably lower, and the difference between groups was statistically significant ( P < 0.05 ). With regard to the cognitive and physical function recovery after treatment, the MoCA score and Fugl-Meyer score of the research group were remarkably higher, and the difference between groups was statistically significant( P < 0.05 ). The quality of life scores was compared. After treatment, the quality of life scores decreased. In comparison with the two groups, the scores of physiological function, psychological function, social function, and healthy self-awareness of the research group were lower, and the difference between groups was statistically significant ( P < 0.05 ). The incidence of postoperative complications in the research group was significantly lower than that in the control group, and the difference between groups was statistically significant ( P < 0.05 ). Conclusion. Compared with conventional craniotomy, neuroendoscopic surgery can remarkably reduce the operation time and blood loss, enhance the hematoma clearance rate, and have a better prognosis, which is more conducive to the recovery of postoperative neurological function, life activities, and quality of life of patients.

Neuroendoscopy in Acute and Severe Neurological Diseases: A Promising Approach for Improved Patient Outcomes

“…Neuroendoscopy has emerged as an effective minimally invasive technique for treating acute and severe neurological diseases. This approach has several advantages over traditional open surgery, including less trauma to surrounding tissues, faster recovery times, and lower complication rates [13] .…”

Comparison of the efficacy of neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal in treatment of hypertensive cerebral hemorrhage

“…Nevertheless, for supratentorial hematoma > 30 mL with significant peri-hematoma edema and midline shift and for subratentorial hematoma > 10 mL with significant intracranial hypertension and cerebellar symptoms, impaired consciousness and progressive worsening of the condition may occur. Brain herniation after a brain hemorrhage with dilated pupils on one side and loss of response to light, intracerebroventricular hematoma or presence of obstructive hydrocephalus should be treated with aggressive surgical procedures [ 10 – 12 ]. The main objective of surgery is to relieve the pressure of an intracerebral hematoma on surrounding brain tissue, relieve intracranial hypertension, minimize secondary brain damage caused by hematoma compression, save patients’ lives and improve patients’ healing and quality of life.…”

Comparison of the efficacy of neuronavigation-assisted intracerebral haematoma puncture and drainage with neuroendoscopic haematoma removal in the treatment of hypertensive cerebral haemorrhage

“…Current treatment for HICH includes conservative medication and surgery, However, the surgical management of HICH is controversial and there is no uniform standard for surgical indications, timing and choice of surgical approach. Nevertheless, for supratentorial haematoma > 30 mL with signi cant peri-haematoma oedema and midline shift, and for subratentorial haematoma > 10 mL with signi cant intracranial hypertension and cerebellar symptoms, impaired consciousness and progressive worsening of the condition; When brain herniation is present after a brain haemorrhage with dilated pupils on one side and loss of response to light; Intracerebroventricular haematoma cast or presence of obstructive hydrocephalus; All should be treated with aggressive surgical procedures [11][12][13] . The main objective of surgery is to relieve the pressure of the intracerebral haematoma on the surrounding brain tissue, relieve intracranial hypertension, minimise secondary brain damage caused by haematoma compression, save the patient's life and improve the patient's healing and quality of life.…”