Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12920
Peer-review started: July 24, 2022
First decision: September 25, 2022
Revised: October 1, 2022
Accepted: November 17, 2022
Article in press: November 17, 2022
Published online: December 16, 2022
Chronic subdural hematoma (CSDH) is a common disease in neurosurgery. The traditional treatment methods include burr hole drainage, bone flap craniectomy and other surgical methods. Complications include recurrence, pneumocephalus, infection and so on. With the promotion of neuroendoscopic technology, its treatment effect and advantages need to be further evaluated.
At present, neuroendoscopic technology has been applied in many neurosurgical operations, and it has certain advantages in the treatment of CSDH, which has been gradually carried out in many units. Its treatment effect and advantages need to be further evaluated.
To study the clinical effect of endoscopic small bone approach in CSDH.
A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method: the neuroendoscopy group (n = 61 cases) and the burr hole drainage group (n = 61 cases). The clinical treatment effect of the two groups of patients with CSDH was compared.
At the early postoperative stage (1 d and 3 d), the proportion of 1/2 re-expansion of the brain tissue in the hematoma cavity and the proportion of complete re-expansion was higher in the neuroendoscopy group than in the burr hole drainage group, and the difference between the two groups was statistically significant (P < 0.05). The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group, and the difference between the two groups was statistically significant (P < 0.05). No intracranial hematoma, low cranial pressure, tension pneumocephalus or other complications occurred in the neuroendoscopy group.
The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up. The surgical effect is apparent with few complications and definite curative effect, which is worthy of clinical promotion and application.
This is a 4-year case study at a single center. The number of cases was small, but we were satisfied with the results of this study, which gives us the confidence to carry out further research studying the corresponding technology, summarizing the indications better and providing support for better clinical work. In the next step, we will apply for further multicenter studies.