Keyhole endoscopic hematoma evacuation in patients.
OBJECTIVE
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.


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).


CONCLUSIONS
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.
The Second Affiliated Hospital, Xi'an Jiaotong University, Department of Neurosurgery, Xi'an, China.
Hongwei
H
Zhu
Zhanxiang
Z
Wang
Wei
W
Shi
D000328:Adult; D000368:Aged; D020145:Basal Ganglia Hemorrhage / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D003399:Craniotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000401:mortality; D044583:Neuroendoscopy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome