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  • Endoscopic Evacuation of Basal Ganglia Hemorrhage via Keyhole Approach Using an Expendable Cannula in Comparison with Craniotomy

    Final Number:

    Zhengcun Yan, Hengzhu Zhang, Yuping Li

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Neuroendoscopic (NE) surgery as a minimal invasive treatment for basal ganglia haemorrhage is a promising approach. The present study aims to evaluate the efficacy and safety of NE approach of applying an expendable cannula on the management of basal ganglia hemorrhage.

    Methods: In this study, we analysed the clinical and radio-graphical outcomes between NE group (21 cases) and craniotomy group (30 cases). The clinical and radio-graphical outcomes included Mortality, hematoma volume, evacuation rate, infection rates, Glasgow Coma Scale (GCS) scores, Modified Rankin Scale (mRS), and Glasgow Outcome Scale (GOS).

    Results: Mortality rate between the 2 groups did not show statistically significant differences (P=0.27). The evacuation rate was significantly higher in the NE group compared to the craniotomy group (P=0.02), and the rate of infection was lower in the NE group compared to the craniotomy group (P=0.04). Operation time (P<0.00001) and mean NICU stay (P=0.005) were significantly shorter in the NE group than in the craniotomy group. Patients in the NE group had good functional outcomes (GFO) than patients in the craniotomy (P=0.04).

    Conclusions: The results indicated NE surgery is an effective and safe approach for basal ganglia haemorrhage, and it is also suggested NE may promote a good functional recovery. However, NE approach only suit to the selected patient, and the usefulness of NE approach needs further RCTs to evaluate.

    Patient Care: applying the NE approach using expendable cannula to treat basal ganglia haemorrhage results in high evacuation rate, better functional recovery, and patients did not need cranioplasty. The results of our study further confirm the potential benefits of utilizing the NE approach. Certainly, our study has several potential limitations. This study involved a relatively small patient group. It is our hope that a larger randomized control trial will be performed to evaluate the use of the NE approach for the treatment of SICH patients.

    Learning Objectives: basal ganglia haemorrhage have begun to be approached using the technique of NE. This study presented a new expendable cannula applying in NE approach. At the first medical college affiliated with Yangzhou University, we have been applying the minimally invasive technique of NE approach to evacuate intracerebral hematomas since 2011. Here, we compared the clinical and radiological outcomes of two treatment groups (NE group vs. traditional craniotomy group). The goals of this study are to evaluate the effectiveness and safety of the NE approach to basal ganglia haemorrhage patients, as compared to the craniotomy approach, and to analyze the influences behind the surgical outcomes.

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