Hongwei Zhu1, Zhanxiang Wang, Wei Shi. 1. The Second Affiliated Hospital, Xi'an Jiaotong University, Department of Neurosurgery, Xi'an, China.
Abstract
AIM: Keyhole endoscopy is a promising therapeutic option for spontaneous intracerebral hemorrhage (ICH). We sought to compare the clinical outcomes between keyhole endoscopy surgery and craniotomy for basal ganglia ICH. MATERIAL AND METHODS: The authors performed a retrospective analysis of the clinical and radiographic data obtained in 28 keyhole endoscopic procedures and 30 craniotomy procedures. Hematoma evacuation rate, infection rate, rebleeding and meanoperation time were recorded as primary end points. Outcome Scale (GOS) values were recorded at the 3-month postoperative follow-up. The operation time from symptom onset is also studied between < 8 hours group and 8-24 hours group. RESULTS: The evacuation rate was significantly higher in the endoscopy group compared with the craniotomy group (P < 0.05), and infectious rate was lower in the endoscopy group compared with the craniotomy group( P < 0.05). Mortality rates between the 2 groups did not show statistically significant differences. The patients operated within 8h had better outcome (GOS 4 and 5) than that operated between 8-24h (p < 0.05). CONCLUSION: The data indicate that in patients with ICH, keyhole endoscopic surgery is safe and feasible, while operation within 8h can promote recovery of patients. These preliminary results warrant further study in a large, prospective, randomized trial in the near future.
RCT Entities:
AIM: Keyhole endoscopy is a promising therapeutic option for spontaneous intracerebral hemorrhage (ICH). We sought to compare the clinical outcomes between keyhole endoscopy surgery and craniotomy for basal ganglia ICH. MATERIAL AND METHODS: The authors performed a retrospective analysis of the clinical and radiographic data obtained in 28 keyhole endoscopic procedures and 30 craniotomy procedures. Hematoma evacuation rate, infection rate, rebleeding and mean operation time were recorded as primary end points. Outcome Scale (GOS) values were recorded at the 3-month postoperative follow-up. The operation time from symptom onset is also studied between < 8 hours group and 8-24 hours group. RESULTS: The evacuation rate was significantly higher in the endoscopy group compared with the craniotomy group (P < 0.05), and infectious rate was lower in the endoscopy group compared with the craniotomy group( P < 0.05). Mortality rates between the 2 groups did not show statistically significant differences. The patients operated within 8h had better outcome (GOS 4 and 5) than that operated between 8-24h (p < 0.05). CONCLUSION: The data indicate that in patients with ICH, keyhole endoscopic surgery is safe and feasible, while operation within 8h can promote recovery of patients. These preliminary results warrant further study in a large, prospective, randomized trial in the near future.
Authors: Christopher Beynon; Patrick Schiebel; Julian Bösel; Andreas W Unterberg; Berk Orakcioglu Journal: Neurosurg Rev Date: 2015-02-17 Impact factor: 3.042