Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage

Gui, Chengjia; Gao, Yikuan; Huang, Dan; Yang, Xinyu

doi:10.12669/pjms.35.2.463

Cited by 22 publications

(10 citation statements)

References 18 publications

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“…Inclusion criteria for this study were: (1) confirmation of unilateral supratentorial intracerebral hemorrhage (which could be accompanied by hematoma rupture into the ventricle) by computed tomography (CT); (2) basal ganglia hemorrhage > 30 ml; (3) subcortical hemorrhage > 30 ml and midline displacement > 5 mm; and (4) surgical treatment was performed within 6-24 h of onset of spontaneous ICH. Exclusion criteria for this study were: (1) intracerebellar hemorrhage; (2) intracranial vascular malformations, aneurysms, or intracerebral hemorrhage caused by brain trauma or brain tumor in patients older than 75 years; (3) cerebral hernia requiring standard large craniotomy; (4) patients with severe systemic diseases or coagulation disorders who could not tolerate surgery; (5) patients or their families who did not agree with surgery and did not sign the informed consent; (6) bleeding > 60 ml; or (7) a GCS score ≤ 6.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

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Endoscopic surgery versus minimal puncture drainage surgery for treatment of supratentorial intracerebral hemorrhage

Xiao

Wan²,

Qu³

et al. 2019

Turkish Neurosurgery

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AIM:To compare neuroendoscopy versus minimal puncture drainage for surgical treatment of supratentorial hypertensive intracerebral hemorrhage.MATERIAL and METHODS: A total of 108 cases involving supratentorial intracerebral hemorrhage were retrospectively analyzed. In 30 cases, endoscopic surgery was performed, while 78 cases involved puncture surgery. We compared hematoma clearance rate, postoperative rebleeding rate, incidence of postoperative complications, operation duration, and Glasgow coma score seven days after surgery. Clinical data such as early postoperative rehabilitation time, Glasgow outcome score three months after surgery, and intensive care unit (ICU) stay were also compared between the two groups. RESULTS:The results showed that endoscopic surgery was associated with a superior clinical therapeutic effect in hematoma clearance rates, GCS scores on postoperative day 7, the average ICU stay, early postoperative rehabilitation time and intracranial infection outcomes than minimal puncture drainage surgery for the treatment of supratentorial intracerebral hemorrhage (p<0.05). Three months after surgery, the favorable prognosis rate in the endoscopic treatment group was significantly higher than that in the craniotomy group [83.3% (28/34) vs. 61.5% (31/51), respectively; χ 2 =4.698, p=0.030]. In contrast, no significant differences in rebleeding, pulmonary infection, tracheotomy, secondary epilepsy, gastrointestinal hemorrhage, death in late postoperative period, or in baseline parameters were observed between the two groups (p>0.05). CONCLUSION:Endoscopic surgery potentially represents a beneficial surgical procedure for treatment of supratentorial spontaneous intracerebral hemorrhage.

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Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…While traditional treatments are recognized, there remains a lack of consensus regarding standardized treatment (2,21,27). In recent years, an increasing number of studies have indicated that use of endoscopy to remove hematomas is less invasive and more effective (7,23).…”

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confidence: 99%

Endoscopic surgery versus minimal puncture drainage surgery for treatment of supratentorial intracerebral hemorrhage

Xiao

Wan²,

Qu³

et al. 2019

Turkish Neurosurgery

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“…[ 6 ] However, intracranial surgery often requires the indwelling of various drainage tubes, and the risk of complications such as rebleeding and pulmonary infection is high. [ 7 , 8 ] Therefore, the prevention and treatment of related complications after intracranial surgery is essential.…”

Section: Introductionmentioning

confidence: 99%

The risk factors for the postoperative pulmonary infection in patients with hypertensive cerebral hemorrhage

Du²,

Shan³

et al. 2020

Medicine

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The risk factors for the pulmonary infections after hypertensive cerebral hemorrhage remains unclear. We aimed to investigate the potential risk factors for the postoperative pulmonary infection in patients with hypertensive cerebral hemorrhage. Patients with hypertensive cerebral hemorrhage undergone surgery from January 2018 to December 2019 were included. Related personal and medical information were collected. Univariate and multivariate logistic regression analyses were performed to identify the potential risk factors for the postoperative pulmonary infection. A total of 264 patients were included, and the incidence of pulmonary infection for patients with hypertensive cerebral hemorrhage after surgery was 19.70%. Escherichia coli is the most common bacteria of pulmonary infection. Multivariate regression analysis revealed that the preoperative hypoalbuminemia (OR2.89, 1.67∼4.78), tracheotomy (OR5.31, 1.24∼11.79), diabetes (OR4.92, 1.32∼9.80), preoperative GCS (OR5.66, 2.84∼11.21), and the duration of mechanical ventilation (OR2.78, 2.32∼3.61) were the independent risk factors for the pulmonary infection in patients with hypertensive cerebral hemorrhage (all P < .05). Patients with hypertensive intracerebral hemorrhage after surgery have a higher risk of postoperative pulmonary infections, and there are many related risk factors, which should be taken seriously in clinical practice.

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“…With the development of modern imaging technology and the introduction of stereotactic, navigation, robotic, and other procedures, minimally invasive surgery to accomplish puncture drainage is increasingly being applied in the clinical setting. However, this procedure shows no significant difference in surgical benefits compared with small bone window surgery (17).…”

Section: Discussionmentioning

confidence: 90%

Low-Cost, Accurate, Effective Treatment of Hypertensive Cerebral Hemorrhage With Three-Dimensional Printing Technology

Ding

Wang

et al. 2021

Front. Neurol.

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Background: Hypertensive intracerebral hemorrhage (HICH) is an acute, severe neurosurgical disease. Puncture drainage of the hematoma has gradually been accepted as a surgical treatment for HICH because of its minimally invasive nature. The precision of the puncture is extremely high because of particular physiological functions. This study was performed to explore the effect of a navigation mold created by three-dimensional printing (3DP) technology in the surgical treatment of HICH.Material and methods: We conducted a retrospective analysis of all consecutive patients with ICH treated with minimally invasive surgery using 3DP navigation or craniotomy to remove the hematoma through a small bone window at the Binzhou Medical University Hospital from June 2017 to March 2019. In total, 61 patients were treated with minimally invasive surgery using 3DP navigation (3DP group), and 67 patients were treated with craniotomy to remove the hematoma through a small bone window (craniotomy group). A comparative study of the two groups was conducted to assess the preoperative and postoperative conditions.Results: The duration of the surgery was significantly longer in the craniotomy group than in the 3DP group (3.27 ± 1.14 h vs. 1.52 ± 0.23 h). Postoperative complication rates were significantly lower in the 3DP group than in the craniotomy group (18.0 vs. 34.3%). Moreover, the rate of patients with a Glasgow Outcome Scale score ≥4 points was not statistically significantly different in the two groups.Conclusion: Minimally invasive surgery assisted by 3DP navigation to treat patients with HICH appears to be safe and effective. The 3DP technique may improve the individualization and accuracy of the surgery.

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Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage

Cited by 22 publications

References 18 publications

Endoscopic surgery versus minimal puncture drainage surgery for treatment of supratentorial intracerebral hemorrhage

Endoscopic surgery versus minimal puncture drainage surgery for treatment of supratentorial intracerebral hemorrhage

The risk factors for the postoperative pulmonary infection in patients with hypertensive cerebral hemorrhage

Low-Cost, Accurate, Effective Treatment of Hypertensive Cerebral Hemorrhage With Three-Dimensional Printing Technology

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