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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Guo, Chen Bai, Yang Zhang, Xiaobin Zhang, Pinjing Han, Song Fan, Di |
| Abstract | Background and aims Endoscopic surgery (ES) and small bone window craniotomy (SBWC) are commonly used methods for hematoma removal in cases of intracerebral hemorrhage (ICH). However, their long-term efficacy and safety remain uncertain. Methods A systematic search was performed in the PubMed, Embase, and Cochrane Library databases from inception to June 30, 2024. The primary outcomes assessed were the 6-month favorable functional outcome rate and the hematoma evacuation rate. Following the meta-analysis, a trial sequential analysis (TSA) was conducted to validate the findings. Results Six randomized controlled trials were included in the meta-analysis. ES demonstrated a higher 6-month favorable functional outcome rate compared to SBWC (56.8% vs. 48.0%, relative risk [RR] 1.20, 95% confidence interval [CI] 1.05–1.38, I2 = 28%), with TSA supporting this result. The hematoma evacuation rate was also higher in the ES group (mean difference [MD] 6.41, 95% CI 1.83–10.99, I² = 95%); however, the TSA did not support this result due to the potential false-positive. Additionally, ES was associated with shorter operation times, less blood loss during surgery, and a lower pneumonia rate compared to SBWC (MD -112.35, 95% CI -165.27 to -59.43; MD -151.22, 95% CI -279.60 to -22.84; RR 0.68, 95% CI 0.51–0.91). Conclusions The meta-analysis and TSA indicate that ES offers better long-term efficacy, shorter operation times, less blood loss, and a lower rate of pneumonia compared to SBWC. Therefore, prioritizing ES over SBWC for treating ICH appears to be a reasonable approach. |
| Related Links | https://bmcneurol.biomedcentral.com/counter/pdf/10.1186/s12883-025-04023-9.pdf |
| Ending Page | 12 |
| Page Count | 12 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712377 |
| DOI | 10.1186/s12883-025-04023-9 |
| Journal | BMC Neurology |
| Issue Number | 1 |
| Volume Number | 25 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2025-02-08 |
| Access Restriction | Open |
| Subject Keyword | Neurology Neurochemistry Neurosurgery Spontaneous supratentorial intracerebral hemorrhage Endoscopic surgery Small bone window craniotomy Meta-analysis Trial sequential analysis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) |
| Journal Impact Factor | 2.2/2023 |
| 5-Year Journal Impact Factor | 2.5/2023 |
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