Where to make burr hole for endoscopic hematoma removal against intracerebral hemorrhage at the basal ganglia to increase the hematoma removal rate - Comparison between trans-forehead and along-the-long-axis approaches

Masahito Katsuki, Norio Narita, Kanako Sato, Ryuzaburo Kochi, Taketo Nishizawa, Kokoro Kawamura, Naoya Ishida, Ohmi Watanabe, Siqi Cai, Shinya Shimabukuro, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Endoscopic hematoma removal is performed to treat intracerebral hemorrhage (ICH) at the basal ganglia. In our hospital, young neurosurgical trainees perform it for the only 1st to the 3rd time. We perform a “trans-forehead approach” and hypothesized that our technique would contribute to higher hematoma removal rate and easiness despite their inexperience. We compared our dataset with an open dataset with along-the-long-axis approaches using pre- and intraoperative neuronavigation by well-trained neurosurgeons and tested the utility of our trans-forehead approach. Methods: We retrospectively investigated our 17 consecutive patients with hypertensive ICH who underwent endoscopic hematoma removal using the trans-forehead approach. We obtained the open dataset and compared our data with the 12 patients from the open dataset using the inverse probability weighting method. Operative time, hematoma removal rate, postoperative hematoma volume, Glasgow Coma Scale (GCS) on day 7, and modified Rankin Scale (mRS) at 6 months were assessed as outcomes. Results: The median age was 68 (interquartile range; 58-78) years. Median postoperative hematoma volume, removal rate, operative time, GCS on day 7, and mRS at 6 months were 9 (2-24) mL, 90 (79-98)%, 53 (41-80) min, 13 (12-13), and 4 (2-5), respectively. The weighted generalized estimating equations revealed that operative time was shorter in the along-the-long-axis group, but other items were not significantly different between the two approaches. Conclusion: The hematoma removal rate of endoscopic hematoma removal with the trans-forehead approach by young trainees was not different from that of the along-the-long-axis approach by well-trained neurosurgeons using neuronavigation.

Original languageEnglish
Article numberSNI_887_2020
JournalSurgical Neurology International
Volume12
Issue number41
DOIs
Publication statusPublished - 2021 Feb 3

Keywords

  • Endoscopic hematoma removal
  • Hematoma removal rate
  • Intracerebral hemorrhage
  • Less invasive surgery
  • Training of residents

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Where to make burr hole for endoscopic hematoma removal against intracerebral hemorrhage at the basal ganglia to increase the hematoma removal rate - Comparison between trans-forehead and along-the-long-axis approaches'. Together they form a unique fingerprint.

Cite this