Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2024; 16(8): 317-328
Published online Aug 28, 2024. doi: 10.4329/wjr.v16.i8.317
Traditional craniotomy versus current minimally invasive surgery for spontaneous supratentorial intracerebral haemorrhage: A propensity-matched analysis
Zhen-Kun Xiao, Yong-Hong Duan, Xin-Yu Mao, Ri-Chu Liang, Min Zhou, Yong-Mei Yang
Zhen-Kun Xiao, Yong-Hong Duan, Xin-Yu Mao, Ri-Chu Liang, Min Zhou, Hengyang Key Laboratory of Hemorrhagic Cerebrovascular Disease, Department of Neurosurgery, Hengyang Medical School, University of South China, Hengyang 421000, Hunan Province, China
Yong-Mei Yang, Department of Anatomy, Hengyang Medical School, University of South China, Hengyang 421000, Hunan Province, China
Author contributions: Xiao ZK was responsible for conceptualization, software, formal analysis, investigation, resources, writing original draft preparation, visualization, and supervision; Xiao ZK and Mao XY were responsible for methodology; Duan YH and Mao XY were responsible for validation; Xiao ZK, Mao XY, and Zhou M were responsible for data curation; Xiao ZK and Liang RC were responsible for writing review and editing; Duan YH was responsible for project administration and funding acquisition; all authors have read and agreed to the published version of the manuscript.
Supported by The Technology Innovation Guidance Programme of Science and Technology, Department of Hunan Province, No. 2020SK51708; The Scientific Research Programme of Hunan Provincial Health Commission, No. B2019110 and No. 20201959; and The Hunan Nature Science Foundation, No. S2023JJMSXM1898.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Institutional review board statement: The study was reviewed and approved by The Clinical Research Ethics Committee, The Second Affiliated Hospital of University of South China (Approval No. 2023019).
Informed consent statement: As the article was a retrospective study, the application for exemption from informed consent was approved by the Clinical Research Ethics Committee of the Second Affiliated Hospital of University of South China.
Data sharing statement: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yong-Mei Yang, PhD, Department of Anatomy, Hengyang Medical School, University of South China, No. 28 Changsheng Road, Hengyang 421000, Hunan Province, China. yangym-nhu@163.com
Received: April 17, 2024
Revised: July 15, 2024
Accepted: July 23, 2024
Published online: August 28, 2024
Processing time: 132 Days and 23.4 Hours
Abstract
BACKGROUND

Minimally invasive surgery (MIS) and craniotomy (CI) are the current treatments for spontaneous supratentorial cerebral haemorrhage (SSTICH).

AIM

To compare the efficacy and safety of MIS and CI for the treatment of SSTICH.

METHODS

Clinical and imaging data of 557 consecutive patients with SSTICH who underwent MIS or CI between January 2017 and December 2022 were retrospectively analysed. The patients were divided into two subgroups: The MIS group and CI group. Propensity score matching was performed to minimise case selection bias. The primary outcome was a dichotomous prognostic (favourable or unfavourable) outcome based on the modified Rankin Scale (mRS) score at 3 months; an mRS score of 0–2 was considered favourable.

RESULTS

In both conventional statistical and binary logistic regression analyses, the MIS group had a better outcome. The outcome of propensity score matching was unexpected (odds ratio: 0.582; 95%CI: 0.281–1.204; P = 0.144), which indicated that, after excluding the interference of each confounder, different surgical modalities were more effective, and there was no significant difference in their prognosis.

CONCLUSION

Deciding between MIS and CI should be made based on the individual patient, considering the hematoma size, degree of midline shift, cerebral swelling, and preoperative Glasgow Coma Scale score.

Keywords: Cerebral haemorrhage; Intracerebral haemorrhage; Minimally invasive surgery; Craniotomy; Propensity-matched analysis

Core Tip: We compared the efficacy and safety of minimally invasive surgery (MIS) and craniotomy (CI) for spontaneous supratentorial cerebral haemorrhage in 557 patients. The prognostic outcome, based on the modified Rankin Scale (mRS) score at 3 months, was evaluated, an mRS score of 0–2 was considered favourable. Before propensity score matching, those who received MIS had a better outcome; however, after accounting for confounding variables, the prognosis was comparable to patients who underwent CI. Deciding between MIS and CI depends on the individual patient, considering the hematoma size, degree of midline shift, cerebral swelling, and preoperative Glasgow Coma Scale score.