Full Visualization of Contact Endoscopy for Basal Ganglia Hemorrhage: A Multicenter Retrospective Study Comparing...

Area of Science:

• Neurosurgery
• Neurology
• Medical Technology

Background:

• Basal ganglia hemorrhage (BGH) is a severe form of intracerebral hemorrhage requiring surgical intervention.
• Surgical evacuation aims to reduce hematoma volume and improve patient outcomes.
• Comparing different surgical visualization techniques is crucial for optimizing BGH treatment.

Purpose of the Study:

• To compare the efficacy and safety of fully visualized contact endoscopy against microscopy and standard neuroendoscopy for BGH surgical evacuation.
• To evaluate the impact of different surgical methods on perioperative outcomes and long-term prognosis in BGH patients.

Main Methods:

• A retrospective, multicenter observational cohort study included 335 BGH patients from January 2021 to May 2024.
• Patients were stratified into microscopy (n=217), neuroendoscopy (n=76), and contact endoscopy (n=42) groups.
• Surgical outcomes, prognostic indicators, and long-term prognosis were assessed using multivariable analysis.

Main Results:

• Endoscopic techniques (neuroendoscopy and contact endoscopy) demonstrated shorter operation times, reduced blood loss, and shorter ICU stays compared to microscopy (P<0.05).
• Endoscopy was associated with significantly lower intracranial infection rates (P<0.0167).
• No significant differences were observed in hematoma evacuation rates or neurological/functional outcomes at 7 days or 3 months across the groups. Older age, hypertension, and larger hematoma volume predicted poor long-term outcomes, not surgical technique.

Conclusions:

• Microscopy, neuroendoscopy, and contact endoscopy are all effective for hematoma evacuation and survival in BGH.
• Endoscopic approaches may provide enhanced perioperative safety without compromising long-term results.
• Contact endoscopy presents a safe and feasible surgical alternative for managing BGH.