The intra-neuroendoscopic technique (INET): a modified minimally invasive technique for evacuation of brain parenchyma hematomas

Zhang, Yujuan1; Shan, Ai-Jun2; Peng, Yu-Ping3; Lei, Pengfei2; Xu, Jianzhong2; Zhong, Xianliang2; Du, Bo2

2019-05-06

10.1186/s13017-019-0239-0

World Journal of Emergency Surgery   影响因子和分区

1749-7922

BackgroundMinimally invasive endoscopic hematoma evacuation is widely used in the treatment of intracerebral hemorrhage. However, this technique still has room for improvement. The intra-neuroendoscopic technique (INET) is a modified minimally invasive technique, and we report its safety and efficacy in evacuating brain parenchyma hematomas by comparing it with cranial puncture and drainage operation (CPDO).MethodsThe frontal, temporal, or occipital approaches were used according to the site of bleeding. The preoperative and postoperative hematoma volumes, Glasgow Coma Scale (GCS) score, Cerebral State Index (CSI), hematoma evacuation rate, operation time, complications, and 30-day mortality and Glasgow Outcome Scale (GOS) were retrospectively compared between the two groups.ResultsA total of 98 patients were enrolled. The evacuation rate (84 7.1% versus 51.0 8.4%, p = 0.00), 7-day GCS (11.8 +/- 1.2 versus 10.4 +/- 1.5, p = 0.01), and CSI (87.1 +/- 8.7 versus 80.6 +/- 10.2, p = 0.02) were higher, and the 30-day mortality rate (1.9% versus 15.6%, p = 0.036) was lower in the INET group. However, the operation time was longer in the INET group than in the control group (65.2 +/- 12.5min versus 45.6 +/- 10.9min, p = 0.000). Multivariable logistic regression showed that a good medium-term outcome (GOS scores 4-5) was significantly associated with INET (odds ratio (OR) 3.514, 95% confidence interval (CI) 1.463-8.440, p = 0.005), age under 65years (OR 1.402, 95% CI, 1.041-1.888, p = 0.026), and hematoma volume less than 50ml (OR 1.974, 95% CI 1.302-2.993, p = 0.001).Conclusions INET surgery for brain parenchyma hematoma evacuation is a safe and efficient modified technique. This technique is minimally invasive, has less complications, and may be helpful in providing optimal outcomes for selected patients.Trial registration ClinicalTrials.gov, NCT02515903. Registered on 5 August 2015.

Intra-neuroendoscopy technique (INET) Transparent sheath Brain parenchyma hematoma Minimally invasive surgery Outcome

SCI

英语

第一 ; 通讯

Guangdong Medical Science and Technology Research Fund Project[A2016545]

Emergency Medicine ; Surgery

Emergency Medicine ; Surgery

WOS:000467287400001

BMC

Web of Science

1.Southern Univ Sci & Technol, Shenzhen Peoples Hosp, Clin Med Coll 2, Affiliated Hosp 1,Jinan Univ,Dept Ultrasound, Shenzhen 518020, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Shenzhen Peoples Hosp, Clin Med Coll 2, Affiliated Hosp 1,Jinan Univ,Dept Emergency Med, Shenzhen 518020, Guangdong, Peoples R China
3.Southern Med Univ, Nanfang Hosp, Dept Neurosurg, Guangzhou, Guangdong, Peoples R China

Zhang, Yujuan,Shan, Ai-Jun,Peng, Yu-Ping,et al. The intra-neuroendoscopic technique (INET): a modified minimally invasive technique for evacuation of brain parenchyma hematomas[J]. World Journal of Emergency Surgery,2019,14.

Zhang, Yujuan.,Shan, Ai-Jun.,Peng, Yu-Ping.,Lei, Pengfei.,Xu, Jianzhong.,...&Du, Bo.(2019).The intra-neuroendoscopic technique (INET): a modified minimally invasive technique for evacuation of brain parenchyma hematomas.World Journal of Emergency Surgery,14.

Zhang, Yujuan,et al."The intra-neuroendoscopic technique (INET): a modified minimally invasive technique for evacuation of brain parenchyma hematomas".World Journal of Emergency Surgery 14(2019).