Comparison of different minimally invasive surgical methods for hypertensive hemorrhage in basal ganglia

Abstract

Objective To compare the therapeutic efficacy, safety and complication incidence of three minimally invasive surgical procedures for hypertensive hemorrhage in basal ganglia. Methods According to the operation procedure, 78 patients with basal ganglia hemorrhage (GCS 6-12) were divided into endoscopic surgery group, stereotactic burr-hole aspiration group and small bone flap craniotomy group. The time of operation, and the blood loss volume during operation were compared among the 3 groups. CT was reused to calculate the residual volume and clearance rate of hematoma within 2 d after operation. The neurological outcomes, case fatality rate were analyzed after 6 months of the surgery according to the Glasgow Outcome Scale (GOS). Results The small bone flap craniotomy group had the longest operation time [(175.7±55.7) min, P＜0.05]. The blood loss volume [(296.5±158.6)mL] during operation in small bone flap craniotomy group was relatively more than those in the other 2 groups (P＜0.05). The endoscopic surgery group had the highest hematoma clearance rate (84.5%±8.2%,P＜0.05). The therapeutic outcomes evaluated by GOS in the endoscopic surgery group were more satisfactory than those in the other 2 groups (P＜0.05). Conclusions Endoscopic surgery not only leads to less tissue damage, but also has advantages of higher hematoma clearance rate and effective hemostasis resulting in better neurological functional outcomes, therefore is an ideal choice for cerebral hemorrhage patients who has no need of large bone flap craniotomy. Key words: Intracranial hemorrhage, hypertensive; Neurosurgical procedures; Microsurgery