Abstract
Background: Hypertensive intracerebral hemorrhage (HICH) is an acute, severe neurosurgical disease. Puncture drainage of the hematoma has gradually been accepted as a surgical treatment for HICH because of its minimally invasive nature. The precision of the puncture is extremely high because of particular physiological functions. This study was performed to explore the effect of a navigation mold created by three-dimensional printing (3DP) technology in the surgical treatment of HICH.Material and methods: We conducted a retrospective analysis of all consecutive patients with ICH treated with minimally invasive surgery using 3DP navigation or craniotomy to remove the hematoma through a small bone window at the Binzhou Medical University Hospital from June 2017 to March 2019. In total, 61 patients were treated with minimally invasive surgery using 3DP navigation (3DP group), and 67 patients were treated with craniotomy to remove the hematoma through a small bone window (craniotomy group). A comparative study of the two groups was conducted to assess the preoperative and postoperative conditions.Results: The duration of the surgery was significantly longer in the craniotomy group than in the 3DP group (3.27 ± 1.14 h vs. 1.52 ± 0.23 h). Postoperative complication rates were significantly lower in the 3DP group than in the craniotomy group (18.0 vs. 34.3%). Moreover, the rate of patients with a Glasgow Outcome Scale score ≥4 points was not statistically significantly different in the two groups.Conclusion: Minimally invasive surgery assisted by 3DP navigation to treat patients with HICH appears to be safe and effective. The 3DP technique may improve the individualization and accuracy of the surgery.
Highlights
Hypertensive intracerebral hemorrhage (HICH) is a common critical neurosurgical illness with high mortality and disability rates [1,2,3]
The inclusion criteria were [1] a diagnosis of HICH based on the Guidelines for the Diagnosis and Treatment of Cerebral Hemorrhage in China formulated by the Chinese Medical Association in 2014 and confirmed by brain computed tomography (CT); [2] location of the bleeding site at the basal ganglia; Abbreviations: 3DP, three-dimensional printing; CT, computed tomography; GCS, Glasgow Coma Scale; GOS, Glasgow Outcome Scale; HICH, hypertensive intracerebral hemorrhage
61 patients were treated with minimally invasive surgery using 3DP navigation (3DP group), and 67 patients were treated with craniotomy to remove the hematoma through a small bone window
Summary
Hypertensive intracerebral hemorrhage (HICH) is a common critical neurosurgical illness with high mortality and disability rates [1,2,3]. Surgical treatment for HICH mainly involves removing the hematoma by craniotomy or minimally invasive surgery [4,5,6]. Craniotomy removal quickly relieves the compression of the hematoma on brain tissue and effectively stops bleeding, the operation is lengthy, which causes great trauma to the patient; it is expensive [7]. Invasive surgery is widely performed as surgical treatment of HICH because it is a short procedure that causes little trauma and is low cost [8,9,10]. Puncture drainage of the hematoma has gradually been accepted as a surgical treatment for HICH because of its minimally invasive nature. This study was performed to explore the effect of a navigation mold created by three-dimensional printing (3DP) technology in the surgical treatment of HICH
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