Keyhole endoscopic hematoma evacuation in patients

Area of Science:

• Neurosurgery
• Minimally Invasive Procedures
• Neurological Surgery

Background:

• Spontaneous intracerebral hemorrhage (ICH) poses significant treatment challenges.
• Keyhole endoscopy presents a minimally invasive surgical alternative to traditional craniotomy.
• Evaluating the efficacy of keyhole endoscopy versus craniotomy for basal ganglia ICH is crucial.

Observation:

• A retrospective analysis compared 28 keyhole endoscopic procedures with 30 craniotomy procedures for basal ganglia ICH.
• Primary endpoints included hematoma evacuation rate, infection rate, rebleeding, and operation time.
• Glasgow Outcome Scale (GOS) was assessed at 3-month follow-up, with a focus on early (<8h) versus delayed (8-24h) surgical intervention.

Findings:

• Keyhole endoscopy demonstrated a significantly higher hematoma evacuation rate and a lower infection rate compared to craniotomy (P < 0.05).
• No statistically significant difference in mortality rates was observed between the two surgical groups.
• Patients undergoing surgery within 8 hours of symptom onset showed significantly better outcomes (GOS 4 and 5) than those operated between 8-24 hours (p < 0.05).

Implications:

• Keyhole endoscopic surgery is a safe and feasible option for managing spontaneous intracerebral hemorrhage.
• Timely surgical intervention within 8 hours of symptom onset is critical for optimizing patient recovery.
• Further large-scale, prospective, randomized trials are warranted to validate these findings.