Endoscopic-assisted keyhole technique for hypertensive cerebral hemorrhage in elderly patients: a randomized controlled study in 184 patients

Yi, Feng; He, Jiangqing; Liu, Bin; Yang, Likun; Wang, Yuhai

doi:10.5137/1019-5149.jtn.12669-14.0

Cited by 38 publications

(62 citation statements)

References 14 publications

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“…The pooled analysis (Cho et al, 2006;Feng et al, 2016;Zhang et al, 2014) revealed no statistically difference in death between neuroendoscopic surgery and craniotomy (RR = 0.58, 95% CI 0.26-1.29; p = .18) ( Figure 2).…”

Section: Pooled Analysis Of Death After Neuroendoscopic Surgery Vermentioning

confidence: 99%

“…Based on the criteria described in the methods, 206 irrelevant citations were further excluded based on review of titles and abstracts. Finally, a total of 3 RCTs (Cho et al, 2006;Feng, He, Liu, Yang, & Wang, 2016;Zhang et al, 2014) were included in this meta-analysis (Figure 1). The major characteristics of included studies are depicted in Table 1.…”

Section: Overview Of Literature Search and Study Characteristicsmentioning

confidence: 99%

“…The random-effects model was used to pool data on complications (Cho et al, 2006;Feng et al, 2016;Zhang et al, 2014). The pooled TA B L E 1 The primary characteristics of the eligible studies in more detail data showed that neuroendoscopic surgery had a lower risk of complications (RR = 0.37, 95% CI 0.28-0.49; p < .001) ( Figure 3).…”

Section: Pooled Analysis Of Complications After Neuroendoscopic Surmentioning

confidence: 99%

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Efficacy of neuroendoscopic surgery versus craniotomy for supratentorial hypertensive intracerebral hemorrhage: A meta‐analysis of randomized controlled trials

et al. 2019

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BackgroundHypertensive cerebral hemorrhage (HCH) is a potentially life‐threatening neurological condition with an extremely high morbidity and mortality. In recent years, neuroendoscopy has been used to treat intracerebral hemorrhage (ICH). However, the choice of neuroendoscopic surgery versus craniotomy for patients with intracerebral hemorrhages is controversial.AimWe conducted this meta‐analysis to assess the efficacy of neuroendoscopic surgery compared with craniotomy in patients with supratentorial hypertensive ICH.MethodsA systematic electronic search was conducted of online electronic databases: PubMed, Embase, and the Cochrane Library updated on December 2017. The meta‐analysis only included randomized controlled studies.ResultsThree randomized controlled trials met our inclusion criteria. The pooled analysis of death showed that neuroendoscopic surgery decreased the rate of death when compared with craniotomy (RR = 0.58, 95% CI 0.26–1.29; p = .18). The pooled result of complications indicated that neuroendoscopic surgery has a tendency toward lower complications (RR = 0.37, 95% CI 0.28–0.49; p < .001).ConclusionsOur results suggested that neuroendoscopic surgery has lower complications, but no superior advantages in morbidity rates. Since the advantage of neuroendoscopic surgery has been performed in some area, the continuation of multi‐center comparative investigation with craniotomy may be necessary. Moreover, some efforts need to be taken in selecting appropriate patients with different treatments.

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Section: Pooled Analysis Of Death After Neuroendoscopic Surgery Vermentioning

confidence: 99%

Section: Overview Of Literature Search and Study Characteristicsmentioning

confidence: 99%

Section: Pooled Analysis Of Complications After Neuroendoscopic Surmentioning

confidence: 99%

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Efficacy of neuroendoscopic surgery versus craniotomy for supratentorial hypertensive intracerebral hemorrhage: A meta‐analysis of randomized controlled trials

et al. 2019

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“…Moreover, neuroendoscopic surgery can reduce the stretch on cerebral tissue and reduce operative injury in patients with a deep-seated cerebral hematoma. 30 The procedure is performed with a small scalp incision and bone flap.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Surgical Treatments for Basal Ganglia Hemorrhage and Imaging Factors Affecting Hematoma Evacuation Rate by Neuroendoscopic Surgery

Guo

Lin

Xie

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Background Basal ganglia hemorrhage (BGH) is a devastating neurologic disease with high morbidity and mortality, and its management is still controversial. We evaluated the effectiveness of surgical treatments for BGH and investigated computed tomography (CT) imaging features affecting the hematoma evacuation rate (ER) in patients treated with neuroendoscopic surgery. Materials and Methods A total of 104 BGH patients who underwent craniotomy, burr-hole drainage, or neuroendoscopic surgery were analyzed retrospectively. Clinical characteristics, imaging features, and postoperative complications were compared. Univariate and multivariate regression analyses were applied to identify imaging factors associated with ER. Results A significant difference in ER was observed: 78.4% in patients treated with neuroendoscopic surgery, 33.6% in patients treated with burr-hole drainage, and 82.5% in patients treated with craniotomy (p < 0.001). Similar results were observed for operative time (p < 0.001). Five cases (12.5%) of rebleeding were found in patients treated with burr-hole drainage (p = 0.020). No significant difference was found for pneumonia, intracranial infection, gastrointestinal bleeding, hospital mortality, hospital stay, expenses, 3-day Glasgow Coma Scale (GCS) scores after surgery, or GCS at discharge. The CT imaging feature, the island sign (p = 0.004), was observed as an independent factor correlated with lower ER for neuroendoscopic surgery. Conclusions The benefits and drawbacks of surgical treatments confirmed they have their own indications, and neuroendoscopic surgery may be relatively beneficial for BGH treatment. The island sign was an independent factor affecting ER for neuroendoscopic surgery. Therefore, comprehensive assessment of clinical data, especially the island sign, should be performed preoperatively in BGH patients.

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“…Hematoma drainage surgery is generally performed in elderly patients with hypertensive or traumatic intracerebral hemorrhage，even in chronic subdural hematoma [1][2][3][4] . The original device was widely used in the hematoma drainage surgery treatment technique.…”

Section: Introductionmentioning

confidence: 99%

A Newly Developed Open-End Intracranial Hematoma Drainage Tube

Wanussakul

Yang

et al. 2016

Translational Neuroscience and Clinics

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Objective To design a new open-end intracranial hematoma drainage tube for clinical application. Methods The newly developed device consists of two parts: the plunger and barrel. On one side, the barrel is bullet shaped with an opening tip. The plunger is located in the middle cavity of the tube barrel and extended out at the open-end. It was designed for strengthening the tube barrel and for convenience in performing the drainage procedure. It can be used by inserting the drainage tube into the lesion and pulling out the plunger, whereby blood will forcefully rise up inside the barrel, providing a satisfactory outcome. It is made for effusion drainage purposes. During the procedure, the drainage tip is placed at the deepest part of the intracranial hematoma to completely drain the blood. Moreover, the plunger fits tightly in the tube, preventing leakage during the operation. With the use of the device, brain can be separated. In addition, the device can help reduce the risk of cerebral damage because of the small operating area. The barrel sidewall has matching opening holes bilaterally and equally for exchanging substances between the inner and outer parts. The overlapping ratio in each horizontal pair is around 1/3–1/2. Each pair on the opposite side will form a different pressure. Thus, the opening holes will not easily get blocked with blood clot. Results Blood and accumulated liquid from the deepest part of the intracranial hematoma can be directly drawn through the drainage tube without damaging a large area. The tube does not get blocked easily and allows for complete removal of the hematoma. Conclusions The device is asuitable instrument for clinical application.

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Endoscopic-assisted keyhole technique for hypertensive cerebral hemorrhage in elderly patients: a randomized controlled study in 184 patients

Cited by 38 publications

References 14 publications

Efficacy of neuroendoscopic surgery versus craniotomy for supratentorial hypertensive intracerebral hemorrhage: A meta‐analysis of randomized controlled trials

Efficacy of neuroendoscopic surgery versus craniotomy for supratentorial hypertensive intracerebral hemorrhage: A meta‐analysis of randomized controlled trials

Effectiveness of Surgical Treatments for Basal Ganglia Hemorrhage and Imaging Factors Affecting Hematoma Evacuation Rate by Neuroendoscopic Surgery

A Newly Developed Open-End Intracranial Hematoma Drainage Tube

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