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Clinical efficacy and safety of neuroendoscopic surgery for severe thalamic hemorrhage with ventricle encroachment

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Abstract

To summarize and analyze the clinical efficacy and safety of neuroendoscopic surgery (NES) in the treatment of patients for severe thalamic hemorrhage with ventricle encroachment (THVE). Eighty-three patients with severe THVE were treated in the Neurosurgery Department of Anqing Hospital Affiliated to Anhui Medical University from July 2019 to August 2021. Our study was approved by the ethics committee. The patients were randomly divided into NES group and extraventricular drainage (EVD) group. The hospital stay, Glasgow coma scale (GCS) scores on the 1st and 14th days postoperatively, the incidence of intracranial infections, and the clearance of postoperative hematomas were compared and analyzed between the two groups. The patients had follow-up evaluations 6 months postoperatively. The prognosis was evaluated based on the activity of daily living (ADL) score. A head CT or MRI was obtained to determine whether there was hydrocephalus, cerebral infarction, or other related complications. Eighty-three patients were randomly divided into 41 cases of NES group and 42 cases of EVD group. The length of postoperative hospital stay was 17.42 ± 1.53 days, the GCS scores were 6.56 ± 0.21, and 10.83 ± 0.36 on days 1 and 14, respectively; intracranial infections occurred in 3 patients (7.31%) and the hematoma clearance rate was 83.6 ± 5.18% in the NES group, all of which were significantly better than the EVD group (P < 0.05). After 6 months of follow-up, 28 patients (68.29%) had a good prognosis, 5 patients (12.19%) died, and 4 patients (9.75%) had hydrocephalus in the NES group. In the EVD group, the prognosis was good in 15 patients (35.71%), 12 patients (28.57%) died, and 17 patients (40.47%) had hydrocephalus. The prognosis, mortality rate, and incidence of hydrocephalus in the NES group were significantly better than the EVD group (P < 0.05). Compared to traditional EVD, NES for severe THVE had a higher hematoma clearance rate, and fewer intracranial infections and patients with hydrocephalus, which together improve the clinical prognosis and is thus recommended for clinical use.

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When authors submit a paper to a journal, the authors agree that the data provided in the publication, including the relevant raw data, will be freely available to any researcher who wants to use these for non-commercial reasons without jeopardizing participant anonymity. All data generated or analyzed during this study are included in this published article.

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Funding

The Clinical Science Research Fund of Anhui Medical University, Anhui Province, PR China (2019xkj225).

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Authors and Affiliations

  1. Department of Neurosurgery, Anqing Affiliated Hospital of Anhui Medical University, Anqing, 246003, Anhui Province, People’s Republic of China

    Heping Zhou, Zhengjiang Cha, Min Chen, Qingchao Zhang & Jian Tang

  2. Department of Neurology, Anqing Hospital Affiliated to Anhui Medical University, Anqing, Anhui Province, People’s Republic of China

    Lei Wang

Authors
  1. Heping Zhou
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  2. Zhengjiang Cha
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  3. Lei Wang
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  4. Min Chen
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  5. Qingchao Zhang
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  6. Jian Tang
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Contributions

In this study, Heping Zhou completed the method design, operation, and data analysis; Zhengjiang Cha participated in the operation implementation and technical guidance; Lei Wang completed the data analysis and statistics; Min Chen participated in the method design and project implementation; and Qingchao Zhang and Jian Tang completed patient tracking and follow-up. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Heping Zhou.

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Ethical review

The Ethics Committee review, the experimental design, and the study scheme fully considered the safety and fairness principle. The research content will not cause harm or risk to patients. Under the principle of informed consent, we (the authors) will do our utmost best to protect patients’ rights and privacy, the research content, and results, for which there are no conflicts of interest.

Consent to participate

The experimental protocol was established according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of Anqing Hospital Affiliated to Anhui Medical University. Written informed consent was obtained from the participants or their guardians.

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Any person or any data of any person in this article has provided consent and agreed to publication of the results.

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The authors declare no competing interests.

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Zhou, H., Cha, Z., Wang, L. et al. Clinical efficacy and safety of neuroendoscopic surgery for severe thalamic hemorrhage with ventricle encroachment. Neurosurg Rev 45, 2701–2708 (2022). https://doi.org/10.1007/s10143-022-01782-8

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  • DOI: https://doi.org/10.1007/s10143-022-01782-8

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