Under the Guidance of Transsphenoidal Sellar Dura Small Incision and Small Bone Window Resection of Pituitary Lesions

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.

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Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.463 ◽

2019 ◽

Vol 35 (2) ◽

Cited By ~ 4

Author(s):

Chengjia Gui ◽

Yikuan Gao ◽

Dan Hu ◽

Xinyu Yang

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Cerebral Hemorrhage ◽

Statistical Significance ◽

Control Group ◽

Observation Group ◽

Bone Window ◽

Neuroendoscopic Surgery ◽

Small Bone

Objective: To analyze the effects of neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance through comparing clinical indicators of the two operation modes and to provide a reference for selection of proper minimally invasive surgery. Methods: One hundred and twenty-six patients with hypertensive cerebral hemorrhage who received diagnosis and treatment in our hospital between December 2015 and December 2017 were selected and grouped into an observation group (n=63) and a control group (n=63) using random number table. Patients in the observation group were treated by neuroendoscopic surgery, while patients in the control group were treated by small bone window craniotomy. The surgical condition, clinical effect and prognosis of the two groups were analyzed and compared. Results: Patients in the observation group completed surgery in a shorter time and bled less during operation compared to the control group, and the hematoma clearance rate of the observation group was obviously higher than that of the control group; the differences had statistical significance (P<0.05). The nerve deficiency scale (NDS) scores of the two groups at the postoperative 3rd month were lower than those before surgery (P<0.05), and the activity of daily life (ADL) score at the postoperative 3rd month was higher than that before surgery (P<0.05). The observation group had lower NDS score and higher ADL score compared to the control group, and the differences had statistical significance (P<0.05). The incidence of complications of the observation group was lower than that of the control group after surgery, and the rate of favourable prognosis of the observation group was higher than that of the control group at the postoperative 3rd month (P<0.05). Conclusion: Neuroendoscopic surgery is more effective and safe, causes less bleeding and has better prognosis and nerve function recovery compared to small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage. How to cite this:Gui C, Gao Y, Hu D, Yang X. Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.463 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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