Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage

doi:10.12998/wjcc.v9.i28.8358

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Oct 6, 2021 (publication date) through Dec 21, 2024

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Oct 6, 2021; 9(28): 8358-8365
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8358

Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage

Jian-Hui Wei, Ya-Nan Tian, Ya-Zhao Zhang, Xue-Jing Wang, Hong Guo, Jian-Hui Mao

Jian-Hui Wei, Department of Neurosurgery, Harrison International Peace Hospital, Hengshui 053000, Hebei Province, China

Ya-Nan Tian, Ya-Zhao Zhang, Xue-Jing Wang, Hong Guo, Jian-Hui Mao, Department of Neurology, Harrison International Peace Hospital, Hengshui 053000, Hebei Province, China

Author contributions: Wei JH and Tian YN design the experiment; Zhang YZ drafted the work; Wang XJ, Guo H and Mao JH collected the data; Wei JH and Tian YN analysed and interpreted data; Wei JH, Tian YN and Zhang YZ wrote the article.

Institutional review board statement: This study was approved by the Harrison International Peace Hospital Ethics Committee.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The author declares that there is no conflict of interest between them.

Data sharing statement: No additional data are available.

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: http://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Jian-Hui Mao, MD, Chief Doctor, Department of Neurology, Harrison International Peace Hospital, No. 180 Renmin East Road, Taocheng District, Hengshui 053000, Hebei Province, China. weijianhui2005@126.com

Received: May 27, 2021
Peer-review started: May 27, 2021
First decision: June 24, 2021
Revised: July 2, 2021
Accepted: August 5, 2021
Article in press: August 5, 2021
Published online: October 6, 2021
Processing time: 124 Days and 0.6 Hours

ARTICLE HIGHLIGHTS

Research background

Surgical treatment is a common method for hypertensive cerebral hemorrhage. The traditional craniotomy has a large skull window and good effect on removing edema, which is helpful for patients to pass through the peak period of brain edema. However, patients with this operation should be carried out under general anesthesia, and the wound caused by this operation is large. Therefore, most patients need blood transfusion. Some patients may have stronger edema reaction after surgical treatment, which is not conducive to postoperative recovery of patients.

Research motivation

Explore the application value of neuroendoscopic minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage.

Research objectives

The advantages and disadvantages of hard channel minimally invasive puncture drainage and neuroendoscopic minimally invasive surgery in hypertensive intracerebral hemorrhage were analyzed, which provided a basis for clinical rational selection of surgical treatment.

Research methods

A total of 118 patients with hypertensive cerebral hemorrhage were reviewed. The control group was treated with hard-channel minimally invasive puncture and drainage, and the observation group was treated with endoscopic minimally invasive surgery. The changes of serum P substances, inflammatory factors, National Hospital Stroke Scale (NIHSS) score and Barthel index were recorded, and the surgical related indexes and prognosis of the two groups were compared.

Research results

The operation time and intraoperative blood loss in the observation group were longer than those in the control group, with no advantages. Hematoma clearance rate and good prognosis rate at 48 h and 72 h after operation were higher than those in control group (P < 0.05); Complication rates in both groups not statistically significant (P > 0.05) The inflammatory cytokines, NIHSS score and Barthel index in the postoperative 14 d, observation groups were better than in the control group (P < 0.05).

Research conclusions

Neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage is relatively complex, but hematoma removal is more complete and the effect is better.

Research perspectives

Minimally invasive neuroendoscopic surgery can be more widely used in the treatment of hypertensive cerebral hemorrhage.